Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University Leuven, Leuven, Belgium.
J Oral Rehabil. 2020 Oct;47(10):1212-1221. doi: 10.1111/joor.13058. Epub 2020 Aug 2.
Post-traumatic trigeminal neuropathy (PTN) is a disturbance of function or pathological change of the trigeminal nerve branches following trauma and has an important impact on patient's quality of life (QoL).
To provide diagnostic data on PTN and illustrate differences in aetiology, injured nerve, pain distribution, sensory profile and QoL between PTN subgroups.
1331 patients with painful or non-painful PTN were retrospectively reviewed in two centres, extracting demographic data, time and cause of trauma, clinical findings including signs and symptoms, basic neurosensory testing, imaging modalities, treatments, and QoL or psychosocial assessment.
More females were represented (70%) than males. The inferior alveolar nerve was most frequently damaged (60%) followed by the lingual nerve (28%). Wisdom teeth removal was considered the main cause (48%). Pain was reported in 63% of patients and pain frequency increased with age without clinically significant gender differences. Numbness was reported in 50% of PTN patients. Neurosensory testing showed larger affected dermatome involvement in persistent injuries, with no differences between the non-painful and painful PTN groups. Patient clustering indicated different sensory profile distributions when stratified according to aetiology or affected nerve branch. High interference with lifestyle was reported (78%), and patients suffering from painful PTN had worse QoL and psychosocial outcomes.
Patients with painful PTN had different clinical profiles and lower QoL scores than those with non-painful PTN. Sensory profiles may provide important prognostic and therapeutic information; however, more research is needed to assess the clustering procedure and link these clusters to therapeutic guidelines.
创伤后三叉神经痛（PTN）是创伤后三叉神经分支功能障碍或病理性改变，对患者的生活质量（QoL）有重要影响。
提供 PTN 的诊断数据，并说明 PTN 亚组之间病因、损伤神经、疼痛分布、感觉特征和 QoL 的差异。
在两个中心回顾性分析了 1331 例有疼痛或无疼痛的 PTN 患者，提取人口统计学数据、创伤时间和原因、包括体征和症状在内的临床发现、基本神经感觉测试、影像学检查、治疗方法以及 QoL 或社会心理评估。
女性（70%）多于男性。下牙槽神经最常受损（60%），其次是舌神经（28%）。智齿拔除被认为是主要原因（48%）。63%的患者报告有疼痛，疼痛频率随年龄增加而增加，但无明显性别差异。50%的 PTN 患者报告有麻木。神经感觉测试显示，持续性损伤的受累皮节更大，无疼痛和无疼痛 PTN 组之间无差异。根据病因或受累神经分支对患者进行聚类分析，表明感觉特征分布不同。报告生活方式受到严重干扰（78%），患有疼痛性 PTN 的患者生活质量和社会心理结局更差。
与非疼痛性 PTN 相比，疼痛性 PTN 患者具有不同的临床特征和更低的 QoL 评分。感觉特征可能提供重要的预后和治疗信息；然而，需要进一步研究来评估聚类过程，并将这些聚类与治疗指南联系起来。
