Page 130 - Craniomaxillofacial Implant Surgery - Jeroen P.J. Dings

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Chapter 7
variables in a heterogeneous cohort, the results of the present study should be interpreted with caution.
Clinical studies by using comprehensive questionnaires to assess satisfaction with CMF prosthetic rehabilitation and to determine the subjective perception towards various reconstructive treatment options (Chapters 5 and 6).
Maxillofacial prosthetic rehabilitation – A survey on the quality of life (Chapter 5)
This clinical study assessed the long-term quality of life of 66 patients treated with facial prostheses with different retentive mechanisms over a 14-year period at a Dutch oral and CMF surgery unit. To our knowledge, current validated questionnaires mainly address overall items measuring general Quality Of Life (QOL) and health condition41,42. Our study specifically focused on the subjective analysis of patients with facial prostheses in perceived QOL. Therefore, a new questionnaire was designed to obtain the patient’s perception and treatment satisfaction with their facial prosthesis. The 62-item questionnaire addressed perceptions of comfort, fit and retention, usage, care, quality and durability of prosthetic materials and psychological aspects.
High overall satisfaction rates found in our study with regard to wearing comfort, anatomical fit, color, and anatomical form were comparable with previous studies evaluating QOL of patients with facial prostheses32,42. Important findings in the survey were in the area of social aspects; 1) statistically significant more patients with nasal prostheses felt noticed by others in their environment (p=0.01) and 2) patients with nasal prostheses scored lower, while holding their face in a neutral expression (p=0.04). This may be due to the fact that reconstructions of the nose are more conspicuous in facial appearance43,44.
Fewer patients with auricular prostheses felt embarrassed to show their defect in different social environments (p=0.01). This is in accordance with the findings of Agarwal et al., which describe a high level of comfort and stability on ear prostheses42. Most studies showed a higher confidence with implant-retained prostheses16,45. This was confirmed by the findings of our study, which describe a significant difference for implant-retained versus adhesive-retained facial prostheses with regard to retention and increased ease of placement and removal (p=0.01 and p=0.04).