Vijayabharathi P, Somkuwar Surabhi Rambhau, Rao Santhosh, Galhotra Virat, Selvaraj Uvashri
Department of Dentistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Unit of Prosthodontics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Indian Prosthodont Soc. 2024 Oct 1;24(4):351-358. doi: 10.4103/jips.jips_156_24. Epub 2024 Oct 15.
The study was aimed to evaluate the effect of prosthodontic rehabilitation on psychological status (PS) and quality of life (QoL) in maxillectomy patients of coronavirus disease 2019-associated mucormycosis (CAM).
The study was designed as a prospective and clinical study.
Twenty-four CAM patients undergoing maxillectomy and subsequent prosthetic rehabilitation were included. The treatment involved surgical, intermediate, and definitive obturator delivery at various phases of healing. PS was assessed using the Hospital Anxiety and Depression Scale (HADS), QOL using the European Organization for Research and Treatment of Cancer QoL Questionnaire-Head and Neck Module (EORTC QLQ-HandN35), and the functioning of obturator was assessed utilising the Obturator Functioning Scale (OFS) at various time points: before maxillectomy (T1), 2 weeks after maxillectomy (T2), 2 weeks upon usage of intermediate obturator (T3), just before delivery of definitive obturator (T4), and 12 weeks after the usage of definitive obturator (T5).
Data were analyzed using a social science statistical analysis program (Stata 14.0; StataCorp LLC, Texas, USA). The significance level was chosen <0.05. Shapiro-Wilk test was used to assess the normality of quantitative data. Student's t-test was employed (α =0.05) to evaluate if the patient's PS, QOL, and obturator function had changed over time. The Spearman correlation coefficient (α =0.05) was utilized to evaluate the correlation coefficient between PS, QOL, and obturator function seen at T3 and T5.
Out of 24 enrolled patients, nine were dropped out. HADS-anxiety score was the highest at T1 (18.6 ± 1.2) and HADS-depression score was the highest at T2 (18.8 ± 1.6). HADS scores decreased significantly (P = 0.001) after prosthetic rehabilitation. EORTC QLQ-HandN35 score was the highest at T2 (105.8 ± 29.5), with statistical significance (P = 0.001) after rehabilitation. OFS was the highest at T3 (51.9 ± 3.9) and lowest at T5 (25.4 ± 2.8).
CAM and maxillectomy deliberately affects the PS and QOL. Prosthetic rehabilitation, psychological motivation, and education create greater improvement in PS and QOL. The progress in parameters showed an upward trend with good obturator quality over a period of time.
本研究旨在评估口腔修复对2019冠状病毒病相关毛霉菌病（CAM）上颌骨切除患者心理状态（PS）和生活质量（QoL）的影响。
本研究设计为一项前瞻性临床研究。
纳入24例接受上颌骨切除及后续修复治疗的CAM患者。治疗包括在愈合的不同阶段进行手术、临时和最终赝复体交付。在不同时间点使用医院焦虑抑郁量表（HADS）评估PS，使用欧洲癌症研究与治疗组织生活质量问卷-头颈模块（EORTC QLQ-HandN35）评估QoL，并使用赝复体功能量表（OFS）评估赝复体功能：上颌骨切除术前（T1）、上颌骨切除术后2周（T2）、使用临时赝复体2周后（T3）、最终赝复体交付前（T4）以及使用最终赝复体12周后（T5）。
使用社会科学统计分析程序（Stata 14.0；美国德克萨斯州StataCorp有限责任公司）对数据进行分析。显著性水平设定为<0.05。采用Shapiro-Wilk检验评估定量数据的正态性。采用学生t检验（α =0.05）评估患者的PS、QoL和赝复体功能是否随时间发生变化。利用Spearman相关系数（α =0.05）评估在T3和T5时观察到的PS、QoL和赝复体功能之间的相关系数。
24例入组患者中，9例退出。HADS焦虑评分在T1时最高（18.6±1.2），HADS抑郁评分在T2时最高（18.8±1.6）。修复治疗后HADS评分显著降低（P =0.001）。EORTC QLQ-HandN35评分在T2时最高（105.8±29.5），修复后具有统计学意义（P =0.001）。OFS在T3时最高（51.9±3.9），在T5时最低（25.4±2.8）。
CAM和上颌骨切除术会对PS和QoL产生显著影响。修复治疗、心理疏导和教育能使PS和QoL有更大改善。随着时间推移，各项参数的进展呈上升趋势，赝复体质量良好。
