Sensory retraining: burden in daily life related to altered sensation after orthognathic surgery, a randomized clinical trial.
Sensory retraining: burden in daily life related to altered sensation after orthognathic surgery, a randomized clinical trial.
复制标题
DOI：
10.1111/j.1601-6343.2010.01493.x
复制
发表时间：
2010-08
影响因子：
3.1
通讯作者：
C. Phillips;S. H. Kim;M. Tucker;T. Turvey
中科院分区：
文献类型：
--
作者：
C. Phillips;S. H. Kim;M. Tucker;T. Turvey
目的 评估感觉再训练练习、年龄、性别、手术类型和术前心理困扰对正颌手术 2 年后患者对与感觉改变相关的干扰的感知的长期影响。环境和样本人群 共有 186 名患有发育性牙颌面不协调的受试者参加了一项多中心随机临床试验：一个中心是社区诊所，另一个中心是大学中心。方法和材料受试者被随机分配到两组：BSSO 后的标准护理张口练习或除张口练习之外的一系列渐进式感觉再训练面部练习。在手术后 1、3、6、12 和 24 个月，受试者对面部感觉异常、麻木和嘴唇敏感性丧失进行评分，从“没有问题 (1)”到“严重问题 (7)”。边际比例赔率模型适合每个顺序结果。结果 术后 2 年内，仅进行开放运动的组比感觉再训练运动组报告与麻木和嘴唇敏感性丧失相关的日常活动受到干扰的可能性更高。两组之间的差异相对恒定。老年受试者和术前心理困扰较高的受试者报告称，与面部异常感觉、麻木和嘴唇敏感性丧失相关的负担较高（p < 0.02）。结论 术后观察到的感觉再训练面部锻炼的积极效果随着时间的推移得以维持。在提供有关下颌截骨术后持续感觉改变对日常生活的影响的术前咨询之前，临床医生应考虑患者的年龄和心理健康状况。
OBJECTIVE Assess the long-term effect of sensory retraining exercises, age, gender, type of surgery, and pre-surgical psychological distress on patients' perception of the interference related to altered sensation 2 years after orthognathic surgery. SETTING AND SAMPLE POPULATION A total of 186 subjects with a developmental dentofacial disharmony were enrolled in a multicenter randomized clinical trial: one center was a community-based practice and the other a university-based center. METHODS AND MATERIALS Subjects were randomly allocated to two groups: standard of care mouth opening exercises after BSSO or a progressive series of sensory retraining facial exercises in addition to the opening exercises. At 1, 3, 6, 12, and 24 months after surgery, subjects scored unusual feelings on the face, numbness, and loss of lip sensitivity from 'no problem (1)' to 'serious problem (7)'. A marginal proportional odds model was fit for each of the ordinal outcomes. RESULTS Up to 2 years after surgery, the opening exercise only group had a higher likelihood of reporting interference in daily activities related to numbness and loss of lip sensitivity than the sensory retraining exercise group. The difference between the two groups was relatively constant. Older subjects and those with elevated psychological distress before surgery reported higher burdens related to unusual facial feelings, numbness, and loss of lip sensitivity (p < 0.02). CONCLUSION The positive effect of sensory retraining facial exercises observed after surgery is maintained over time. Clinicians should consider the patient's age and psychological well-being prior to providing pre-surgical counseling regarding the impact on daily life of persistent altered sensation following a mandibular osteotomy.