Panneerselvam Elavenil, Krishnan Rajkumar, Velayudham Jaikumar
Department of Oral & Maxillofacial Surgery, SRM Dental College, SRM Institute of Science & Technology, Ramapuram Campus, Chennai 600089, India.
Department of Oral & Maxillofacial Pathology & Microbiology, SRM Dental College, SRM Institute of Science & Technology, Ramapuram Campus, Chennai 600089, India;
Craniomaxillofac Trauma Reconstr. 2025 Aug 30;18(3):37. doi: 10.3390/cmtr18030037. eCollection 2025 Sep.
Alcohol Use Disorder (AUD) is common among patients with maxillofacial trauma. Conventional perioperative care recommends complete abstinence. However, abrupt cessation can lead to Alcohol Withdrawal Syndrome (AWS), negatively impacting psychological well-being and compliance. This randomized controlled pilot study evaluated the effectiveness of Monitored Therapeutic Alcohol Administration (MTAA) in reducing perioperative stress and enhancing quality of life without impairing fracture healing. Twenty-four adult male patients with AUD and isolated facial fractures requiring surgery were enrolled. They were assigned to either an intervention group (n = 12) receiving MTAA-oral alcohol at 0.5 g/kg/day for two weeks-or a control group (n = 12) undergoing complete abstinence. Outcomes were assessed over six weeks, including stress (Zung Self-Rating Depression Scale), quality of life (Oral Health Impact Profile-14), soft tissue healing (Landry's Index), and hard tissue healing (Moed's Scale, serum osteocalcin). The MTAA group showed significantly reduced stress and improved quality of life ( < 0.001). Healing outcomes were comparable between groups, with no significant differences in soft tissue indices, osteocalcin levels, or radiographic scores. MTAA appears to be a safe and effective strategy to manage AWS-related distress and improve postoperative recovery, offering a practical alternative to strict abstinence in the surgical management of patients with AUD.
酒精使用障碍（AUD）在颌面部创伤患者中很常见。传统的围手术期护理建议完全戒酒。然而，突然戒酒会导致酒精戒断综合征（AWS），对心理健康和依从性产生负面影响。这项随机对照试验性研究评估了监测治疗性酒精给药（MTAA）在减轻围手术期应激和提高生活质量同时又不影响骨折愈合方面的有效性。24名患有AUD且需要手术治疗的孤立性面部骨折成年男性患者被纳入研究。他们被分配到干预组（n = 12），接受每天0.5 g/kg的MTAA口服酒精，持续两周；或对照组（n = 12），完全戒酒。在六周内评估结果，包括应激（zung自评抑郁量表）、生活质量（口腔健康影响概况-14）、软组织愈合（兰德里指数）和硬组织愈合（莫德量表、血清骨钙素）。MTAA组的应激显著降低，生活质量得到改善（P < 0.001）。两组间的愈合结果具有可比性，软组织指数、骨钙素水平或影像学评分无显著差异。MTAA似乎是一种安全有效的策略，可管理与AWS相关的痛苦并改善术后恢复，为AUD患者手术管理中的严格戒酒提供了一种切实可行的替代方案。
