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颞下颌关节强直患者间置成形术后生活质量评估:前瞻性研究。

Quality of life assessment in temporomandibular joint ankylosis patients after interpositional arthroplasty: a prospective study.

机构信息

Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Int J Oral Maxillofac Surg. 2019 Nov;48(11):1448-1455. doi: 10.1016/j.ijom.2019.04.017. Epub 2019 May 18.

Abstract

Temporomandibular joint (TMJ) ankylosis significantly impacts both physical and psychosocial patient wellbeing. A complete evaluation of treatment outcomes necessitates knowing the extent to which a patient's quality of life (QoL) is impacted. This study was performed to evaluate the impact of TMJ ankylosis on QoL in 25 TMJ ankylosis patients treated by interpositional arthroplasty. The patients completed OHIP-14 and UWQoL questionnaires once before and then at 3 months after the surgery. There was a significant improvement in mean cumulative scores for both questionnaires. With the exception of functional limitation, all OHIP domains showed significant improvement. Preoperatively, the worst scores were found in the psychological distress domain, followed by the social handicap, physical pain and physical disability domains. More than half of the subjects (56%) reported having suicidal thoughts. Amongst the individual UWQoL domains, appearance, chewing, anxiety (P <  0.01), recreation and mood (P <  0.05) showed improved scores. Appearance and chewing were the top ranked priority domains before and after surgery. No significant change was found in speech, taste, sleep, or breathing. Psychosocial factors were found to play a much bigger role than previously thought. The physical, psychological, and social factors were intricately related and dynamically interacted with each other. Surgical treatment produced a definitive QoL improvement in the patients.

摘要

颞下颌关节(TMJ)强直显著影响患者的身体和心理社会健康。全面评估治疗效果需要了解患者的生活质量(QoL)受到影响的程度。本研究旨在评估 25 例 TMJ 强直患者接受间置成形术后对 QoL 的影响。患者在手术前和手术后 3 个月各完成一次 OHIP-14 和 UWQoL 问卷。两个问卷的平均累积分数均有显著改善。除了功能受限外,OHIP 的所有领域均有显著改善。术前,心理困扰、社会障碍、身体疼痛和身体残疾等方面的评分最差。超过一半的患者(56%)报告有自杀念头。在 UWQoL 的各个领域中,外观、咀嚼、焦虑(P<0.01)、娱乐和情绪(P<0.05)的评分均有改善。外观和咀嚼是手术前后排名最高的首要问题。言语、味觉、睡眠或呼吸均无明显变化。心理社会因素的作用比之前认为的要大得多。生理、心理和社会因素相互交织并相互作用。手术治疗显著改善了患者的生活质量。

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