Page 91 - Craniomaxillofacial Implant Surgery - Jeroen P.J. Dings

Maxillofacial prosthetic rehabilitation: a survey on the quality of life
DISCUSSION
The data from this study led to the rejection of the null hypothesis that no differences would be found in overall satisfaction between the locations of facial defects and the types of retention for maxillofacial prostheses. Only the placement and removal of the prostheses were shown to be statistically significantly more difficult with adhesive- retained prostheses. No differences could be established between different retention systems and psychological or social aspects. In addressing all important details, the questionnaire was lengthy, containing more than 62 items. However, no remarks about the number of questions were received from any of the respondents.
Although the number of respondents was greater than in previous research and representative of the whole group, one limitation of the present study was the total
number of patients included. Maxillofacial prostheses are sparse, and, as with most
studies, our research was based on a heterogeneous and reduced cohort with different
follow-up periods necessitating greater longitudinal comparison4. Difference in 5 longevity may allow patients with longer survival to develop coping strategies.
The distribution by patient sex (56% male, 44% female) demonstrated similar proportions of the sexes as reported in previous studies23. In contrast with other studies, where women have been shown to be more susceptible to depressive symptoms, no statistical differences for age or sex were observed2. Although the influence of social support on the psychosocial functioning of the individual patient was not evaluated, available support can suppress depressive symptomatology2.
Atay et al3 stressed that patients with nasal prostheses scored worse in all domains of QOL because the nose plays a key role in facial appearance and social interactions. In contrast, no such difference was shown in the present study, with only a few patients with auricular prostheses being embarrassed to show their defect in different social environments (P=.01).
The longevity of maxillofacial prostheses in the present study varied from 0.5 to 10 years with a mean of 26, 17, and 31 months for orbital, nasal, and auricular prostheses. Whether this difference is caused by material properties or behavioral factors such as ‘frequency of removing,’ ‘cleaning,’ or ‘maintaining of the prosthesis’ is unclear. Karakoca et al15 and Hooper et al22 reported a mean life span of maxillofacial prostheses of 1 to 1.5
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