Kim Hye-Kyoung, Kim Mee-Eun
Department of Oral Medicine, College of Dentistry, Dankook University , Cheonan , South Korea.
Somatosens Mot Res. 2019 Sep;36(3):202-211. doi: 10.1080/08990220.2019.1645000. Epub 2019 Aug 1.
This study aimed to characterize the sensory profile of patients with post-implant trigeminal neuropathy and identify the association between subjective symptoms and objective signs including psychophysical testing and radiographic imaging. This study further evaluated to the association between quantitative sensory testing (QST)/qualitative sensory testing (QualST) and the severity of nerve injury graded by radiographic imaging. This retrospective study included 34 patients diagnosed with post-implant trigeminal neuropathy. Data on the neuropathic pain symptom inventory (NPSI), thermal and electric QST, bedside QualST, and cone beam computed tomography (CBCT) was collected and the association between these variables were analysed. Numbness was the most common subjective symptom and evoked pain was the most frequent neuropathic pain. There was no significant correlation between negative and positive symptoms. Spearman's rank correlation analyses indicated that objective findings including QST/QualST correlated with a sensory loss profile rather than a gain of function profile. Moderate positive correlations between some positive symptoms and the score of QualST were observed. The Mann-Whitney test showed that subjective symptoms did not differ according to the severity of nerve damage according to CBCT, but the electric QST and QualST was discriminative. This study suggests that QST/QualST associated with the severity of nerve damage according to CBCT might be useful in assessing numbness in patients with negative and positive symptoms after implant surgery, but may be of marginal utility in the evaluation of neuropathic pain within the limitation of this cross-sectional study with small sample size.
本研究旨在描述植入后三叉神经病变患者的感觉特征,并确定主观症状与包括心理物理学测试和影像学检查在内的客观体征之间的关联。本研究进一步评估了定量感觉测试(QST)/定性感觉测试(QualST)与影像学分级的神经损伤严重程度之间的关联。这项回顾性研究纳入了34例诊断为植入后三叉神经病变的患者。收集了关于神经性疼痛症状量表(NPSI)、冷热和电刺激QST、床边QualST以及锥形束计算机断层扫描(CBCT)的数据,并分析了这些变量之间的关联。麻木是最常见的主观症状,诱发性疼痛是最常见的神经性疼痛。阴性和阳性症状之间无显著相关性。Spearman等级相关分析表明,包括QST/QualST在内的客观结果与感觉丧失特征相关,而非功能增强特征相关。观察到一些阳性症状与QualST评分之间存在中度正相关。Mann-Whitney检验表明,根据CBCT所示的神经损伤严重程度,主观症状并无差异,但电刺激QST和QualST具有鉴别性。本研究表明,根据CBCT,与神经损伤严重程度相关的QST/QualST可能有助于评估植入手术后有阴性和阳性症状患者的麻木情况,但在本小样本横断面研究的局限性内,对神经性疼痛的评估可能作用有限。