Sensory Re-training following Orthognathic Surgery

描述：（由申请人提供）面部感觉异常， 对患者的口腔行为产生负面影响， 患者的生活质量，如果改变的感觉持续存在。许多患者的 异常的感觉保留了一些感觉功能，不会发展成慢性的 疼痛，对于这些人来说，目前还没有证据 非侵入性治疗。该项目的目标是评估感官 再训练，一种康复治疗， 感觉功能受损的患者，无论其原因如何。这 行为治疗方法已经在临床上取得了巨大的成功， 自1970年代以来，手外伤患者。再培训似乎可以提高中央 从受伤的感觉神经到大脑的冲动的重组 这样改变的感觉信号就可以被解释和翻译 有意义的运动功能 感觉再训练将与安慰剂下颌张开运动进行比较， 单盲、随机化、双臂平行组、分层区组临床 试验，使用正颌外科患者作为受试者。正颌外科 患者提供了一个不妥协的模型，用于评估新的康复治疗， 治疗这些健康的患者，接受了矫正牙面畸形的治疗， 目前手术无神经感觉障碍，但仍常规 手术后面部感觉会发生实质性变化 procedure.感觉再训练的效果将使用三个 结果类型：以患者为中心的措施，以评估 手术后感觉改变的负面影响和所需的恢复时间 达到很少或没有负面影响;神经感觉行为措施，以评估 患者学习触觉感知的替代线索的能力， 辨别;和常规的感觉神经接触阈值测量， 评估实际赤字。我们的首要任务是 对感觉改变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.