Ahmad Z, Breeze J, Williams R
Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2GW.
Br J Oral Maxillofac Surg. 2018 Jun;56(5):421-424. doi: 10.1016/j.bjoms.2018.04.003. Epub 2018 Apr 27.
Measures of patient-reported quality of life (QoL) are increasingly being used to tailor services that are funded by Clinical Commissioning Groups (CCG) in England. Mandibular osteotomies may result in altered sensation of the lower lip, but we know of limited evidence about the resulting effect on QoL. The modified Bristol orthognathic patient outcomes questionnaire was given to patients who had mandibular osteotomies at the Queen Elizabeth Hospital, Birmingham, between March 2006 and April 2016. Questionnaires were collected at the final orthognathic postoperative appointment. The significance of the difference in QoL between those who had altered sensation of the lower lip and those who did not was compared using a two-tailed t test. During this period 170 patients had mandibular orthognathic operations. Completed questionnaires were received from 117 of those patients (69%) during this period, after a follow up of about six months. We found no significant difference between the perceived benefits of treatment between the 41 who had altered sensation and the 74 who did not (p=0.30). Only 5/41 who reported residual numbness six months postoperatively stated that they would not choose to have the same treatment again. In conclusion, orthognathic surgery results in an appreciable improvement in QoL and should continue to be funded by CCG in England. Contrary to the perception of some clinicians, those patients with residual numbness of the lip did not have significantly poorer QoL. Future interpretation of the data will be improved if they are collected both before and after the operation.
患者报告的生活质量(QoL)测量方法越来越多地用于定制由英国临床委托小组(CCG)资助的服务。下颌骨截骨术可能会导致下唇感觉改变,但我们所知的关于其对生活质量影响的证据有限。对2006年3月至2016年4月期间在伯明翰伊丽莎白女王医院接受下颌骨截骨术的患者发放了改良版布里斯托尔正颌患者结局问卷。问卷在正颌术后最后一次预约时收集。使用双尾t检验比较下唇感觉改变者和未改变者之间生活质量差异的显著性。在此期间,170例患者接受了下颌正颌手术。在约6个月的随访后,在此期间从其中117例患者(69%)处收到了完整的问卷。我们发现,41例感觉改变者和74例未改变者在治疗感知益处方面没有显著差异(p = 0.30)。术后6个月报告有残留麻木感的41例患者中,只有5例表示不会再次选择相同的治疗。总之,正颌手术可使生活质量得到明显改善,并应继续由英国的CCG资助。与一些临床医生的看法相反,唇部有残留麻木感的患者生活质量并没有明显更差。如果在手术前后都收集数据,未来对数据的解读将会得到改善。