Basic and patient-oriented research
Quality-of-Life Survey Comparing Patients Before and After Discectomy of the Temporomandibular Joint

https://doi.org/10.1016/j.joms.2009.07.092Get rights and content

Purpose

The aim of this study was to assess the quality-of-life (QoL) outcomes of patients who had undergone temporomandibular joint (TMJ) discectomy with dermis-fat grafting compared with a cohort of closely matched patients who had not had surgery.

Materials and Methods

A cross-sectional study of 61 patients was undertaken. All patients completed a TMJ surgery–specific QoL questionnaire. They were divided into 2 groups according to whether they had undergone TMJ discectomy (postsurgical group, n = 32) or not (presurgical group, n = 29). The 2 groups were closely matched for age, gender, clinical presentation, and radiologic diagnoses of Wilkes stage IV TMJ internal derangement.

Results

Post–TMJ surgery patients showed statistically significant decreases in pain levels (P < .05), diet and chewing (P < .01), mood (P < .01), anxiety (P < .01), and general health (P < .05) compared with the presurgical patients. However, there were no statistically significant differences between the pre– and post–TMJ surgery groups in terms of speech, level of activity, recreation, and general well-being.

Conclusion

The results of this study suggest that TMJ discectomy with dermis-fat grafting appears to have a positive QoL effect in terms of reducing pain levels and improving diet and chewing, mood, anxiety, and general health in patients with Wilkes stage IV TMJ internal derangement.

Section snippets

Materials and Methods

Sixty-one patients were enrolled in this study and were asked to complete the TMJ-S-QoL questionnaire. The questionnaire used in this study (Fig 1) was adapted from the UW-QoL-R,7 which contained domains specific for head and neck cancer. Where the term “cancer” appeared in the UW-QoL-R, it was replaced with “TMJ disorder,” with some questions specifically related to head and neck cancer, such as those about the shoulder, saliva, taste, and swallowing, eliminated from the final questionnaire to

Results

All 61 patients (no surgery, n = 29; surgery, n = 32) completed the TMJ-S-QoL questionnaire. For all 9 comparable parameters of the TMJ-S-QoL questionnaire (Fig 1), there was a mean improvement in the postsurgical group patients when compared with the presurgical group (Table 2). This improvement was statistically significant for 5 (pain, diet and chewing, mood, anxiety, and general health) of these parameters (P < .05) (Fig 3). For 4 of the parameters (speech, level of activity, recreation,

Discussion

Many previously published studies on TMJ surgery have looked at a heterogeneous range of patients with different diagnoses undergoing a wide variety of different surgical procedures with outcomes that were difficult or impossible to properly assess.13, 14 This study attempted to bring together a cohort of patients who not only were closely matched in terms of age and gender but also had comparable clinical and radiologic presentations as well as diagnoses that required similar surgical

References (25)

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