Orofacial Pain Division, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
Harvard School of Dental Medicine, Boston, Massachusetts, USA.
J Oral Rehabil. 2022 Aug;49(8):778-787. doi: 10.1111/joor.13335. Epub 2022 May 16.
Following the onset of the COVID-19 pandemic, telemedicine has become rapidly implemented into both medical and dental practices. While guidelines for examination through telemedicine have been described in similar fields of oral medicine and neurology, the framework for a comprehensive telemedicine examination for a patient with symptoms of orofacial pain has not yet been described.
The objective of this study is to introduce the format of a telemedicine examination for a new patient with orofacial pain as well as describe the success and utility of a telemedicine consultation in a hospital-based orofacial pain practice.
A retrospective review was performed of all new telemedicine consults from April 2, 2020, to March 29, 2021. Medical records were reviewed for patient demographics as well as details of the initial telemedicine consult and in-office follow up.
Two hundred seventy new patients were seen. The most common diagnoses were myofascial pain of the masticatory muscles (37%), an articular disc disorder of the TMJ (21%), and TMJ arthralgia (16%), followed by obstructive sleep apnea (9%) and neuropathic orofacial pain (6%). 146 patients returned to the clinic for an in-office follow up, 78.8% of which had an accurate telemedicine diagnosis. Difficulty discerning between masticatory myofascial pain and TMJ arthralgia was the most common reason for inaccuracy during the telemedicine diagnosis.
Telemedicine consultation for patients with orofacial pain can help facilitate an accurate diagnosis and expedite treatment for patients who face challenges presenting for an in-office consultation.
COVID-19 大流行爆发后,远程医疗迅速应用于医学和牙科实践。虽然在口腔医学和神经病学等类似领域已经描述了通过远程医疗进行检查的指南,但尚未描述针对出现颌面疼痛症状的患者进行全面远程医疗检查的框架。
本研究旨在介绍一种新的颌面疼痛患者远程医疗检查的格式,并描述在基于医院的颌面疼痛实践中远程医疗咨询的成功和实用性。
对 2020 年 4 月 2 日至 2021 年 3 月 29 日期间的所有新远程医疗咨询进行回顾性审查。对患者人口统计学信息以及初始远程医疗咨询和门诊随访的详细信息进行病历回顾。
共接待了 270 名新患者。最常见的诊断是咀嚼肌肌筋膜疼痛(37%)、TMJ 关节盘紊乱(21%)和 TMJ 关节炎(16%),其次是阻塞性睡眠呼吸暂停(9%)和神经性颌面疼痛(6%)。146 名患者返回诊所进行门诊随访,其中 78.8%的患者远程医疗诊断准确。远程医疗诊断中最常见的不准确原因是难以区分咀嚼肌肌筋膜疼痛和 TMJ 关节炎。
针对颌面疼痛患者的远程医疗咨询有助于为那些因难以进行门诊咨询而面临挑战的患者提供准确的诊断和快速治疗。