Sensory Re-training following Orthognathic Surgery

描述：(申请人提供)面部感觉异常 对患者的口腔行为产生负面影响，并可能对 如果改变的感觉持续存在，患者的生活质量。许多患者患有 异常感觉保留了一些感觉功能，不会发展为慢性 疼痛，而对于这些人来说，目前没有基于证据的 非侵入性治疗。这个项目的目标是评估感官 再培训，一种康复疗法，提供了巨大的潜力 无论原因如何，感觉功能受损的患者。这 行为疗法已经在临床上取得了很大的成功 自20世纪70年代以来，手部损伤患者。再培训似乎加强了中央 从受损的感觉神经到大脑的冲动的重组 皮层，以便改变的感觉信号可以被解释和翻译 转化为有功能意义的运动功能。 感觉再训练将被比作安慰剂张开嘴巴的练习 单盲、随机双臂平行分组分层麻醉临床研究 试验，以正颌外科患者为研究对象。正颌外科 患者为评估新的康复治疗提供了一个不妥协的模式 治疗。这些健康的患者接受了矫正牙面畸形的治疗， 目前正在接受手术，没有神经感觉损伤，但仍是常规的 手术后面部感觉发生实质性变化 程序。感觉再训练的效果将用三种方法进行评估。 结果类型：以患者为中心的措施，以评估 术后感觉改变的负面影响及所需恢复时间 达到很小或没有负面影响；神经感官行为评估 患者学习触觉和其他提示的能力 以及传统的神经感觉接触阈值测量 评估实际赤字。我们的主要关注点是病人的 对感觉变化对日常生活的负面影响的感知。

DESCRIPTION: (provided by the applicant) Abnormal facial sensation has a negative impact on patient's oral behaviors and may adversely affect a patient's quality of life if the altered sensation persists. Many patients with abnormal sensations retain some sensory function and do not develop chronic pain, and for those individuals there are no currently evidence-based noninvasive therapies. The goal of this project is to evaluate sensory re-training, a rehabilitative therapy that offers significant potential for patients who experience impaired sensory function regardless of the cause. This behavior therapy approach has been used with substantial clinical success with hand injury patients since the 1970s. Re-training appears to enhance central reorganization of the impulses from an injured sensory nerve to the cerebral cortex so that the altered sensory signals can be interpreted and translated into functionally meaningful motor functions. Sensory re-training will be compared to a placebo jaw-opening exercise in a single blind, randomized two-arm parallel group stratified block clinical trial, using orthognathic surgery patients as subjects. Orthognathic surgery patients offer an uncompromised model for the evaluation of new rehabilitative therapies. These healthy patients, treated to correct dentofacial deformity, present for surgery with no neurosensory impairment, but yet routinely experience substantial alterations in facial sensation following the surgical procedure. The effcts of sensory re-training will be evaluated using three types of outcomes: patient-centered measures to assess the magnitude of the negative effect of altered sensation after surgery and the recovery time needed to reach little or no negative effect; neurosensory behavior measures to assess the patient's ability to learn alternate cues for touch perception and discrimination; and a conventional neurosensory contact threshold measure to assess the actual deficit. Our primary focus will be on the patient's perception of the negative impact of altered sensation on daily life.