FACE-Q量表评估机器人辅助下颌角截骨手术效果

FACE-Q scale assessment of surgical outcomes in robot-assisted mandibular angle osteotomy

目的应用FACE-Q量表评估机器人辅助下颌角截骨手术的效果。方法采用临床随机对照研究方法,于2022年1月至2023年6月在郑州大学第二附属医院招募18~40岁的下颌角肥大患者作为研究对象,采用随机化与供应管理系统(Clinflash IRT 2.0)按照1∶1的比例随机分配到试验组和对照组,术前通过2组患者头颅CT数据应用Mimics 21.0软件规划手术路径,确定截骨平面,试验组根据术前截骨方案在机器人辅助下行下颌角截骨术,对照组根据术前设计行传统徒手下颌角截骨术。术后6个月,由患者填写颅面FACE-Q量表对手术效果进行评估,涵盖外观满意度(包括面部、下颌及笑容)、健康相关的生活质量(包括容貌焦虑、心理、社交及语言)、术后功能(包括呼吸、饮食、面部、发音),以及不良反应4个方面共12个指标,每个指标为0~100分,分值越高表明评价越好。使用SPSS 27.0软件处理数据,正态分布计量资料以±s表示,组间比较采用t检验,非正态分布计量资料以M(Q_(1),Q_(3))表示,组间比较采用Mann-Whitney U检验,P<0.05为差异有统计学意义。结果试验组纳入20例患者,男3例,女17例,年龄(27.6±4.4)岁(19~38岁);对照组纳入20例患者,男4例,女16例,年龄(27.4±3.9)岁(19~35岁)。术后随访6个月,2组患者伤口愈合良好,下颌骨肥大均得到不同程度改善,无面瘫、面部歪斜、疼痛等并发症发生。FACE-Q量表评估结果:在外观满意度方面,试验组面部、下颌及笑容3个指标评分分别为(72.2±11.7)、86(77,92)、(63.2±9.5)分,均高于对照组的(49.2±9.9)、43(35.5,50)、(48.0±7.7)分,差异均有统计学意义(P均<0.01);在健康相关的生活质量方面,除语言外,试验组的容貌焦虑、心理、社交3个指标评分均高于对照组[(71.0±11.5)分vs.(49.1±10.3)分,(66.7±11.7)分vs.(45.4±10.5)分,(75.0±9.7)分vs.(56.4±8.5)分],差异均有统计学意义(P均<0.01);在术后功能方面,试验组饮食评分高于对照组[(83.4±10.7)分vs.(71.0±14.9)分](P<0.01),但其他3个指标差异均无统计学意义(P均>0.05);在不良反应方面,2组差异无统计学意义(P>0.05)。结论FACE-Q量表评估结果证实机器人辅助下颌角截骨手术可以显著提高患者术后的外观满意度、心理状态、社会适应性及饮食功能,且不增加并发症的发生率。

ObjectiveTo assess the effectiveness of robot-assisted mandibular angle osteotomy using the FACE-Q questionnaire.MethodsA randomized controlled clinical study was conducted in the Second Affiliated Hospital of Zhengzhou University from January 2022 to June 2023.Patients with mandibular angle hypertrophy aged 18 to 40 years old were recruited as research objects,and a randomization and supply management system(Clinflash IRT 2.0)was used to randomly assign the experimental group and control groups in a 1∶1 ratio.Before surgery,Mimics 21.0 software was used to plan the surgical approach and determine the osteotomy plane based on the head CT data of the two groups.The experimental group underwent robot-assisted mandibular angle osteotomy according to the preoperative osteotomy plan,while the control group underwent traditional manual mandibular angle osteotomy according to the preoperative design.Six months after surgery,patients filled in the FACE-Q craniofacial module scale to evaluate the surgical effect,covering 12 indicators in four aspects:appearance satisfaction(including face,jaw and smile),health-related quality of life(including appearance anxiety,psychology,social interaction and speech),postoperative function(including breathing,diet,face and pronunciation),and adverse reactions.Each indicator was scored from 0 to 100 points,with higher scores indicating better evaluation.SPSS 27.0 software was used to process the data,and the measurement data of normal distribution were expressed by Mean±SD,and t-test was used for comparison between groups.The measurement data of non-normal distribution were expressed by M(Q_(1),Q_(3)),and Mann-Whitney U test was used for the comparison between groups.P<0.05 was considered statistically significant.ResultsThe experimental group included 20 patients,3 males and 17 females,with an age of(27.6±4.4)years(19 to 38 years);the control group included 20 patients,4 males and 16 females,with an age of(27.4±3.9)years(19 to 35 years).Six months postoperatively,all patients in both groups had good wound healing,and the mandibular hypertrophy was improved to varying degrees.There were no complications such as facial paralysis,facial deviation,or pain.The FACE-Q questionnaire results showed that in terms of appearance satisfaction,the scores for the three indicators of face,mandible,and smile in the experimental group were(72.2±11.7),86(77,92),and(63.2±9.5)points,respectively,all higher than those in the control group,which were(49.2±9.9),43(35.5,50),and(48.0±7.7)points,respectively,with statistically significant differences(P<0.01 for all);in terms of health-related quality of life,except for speech,the scores for the three indicators of appearance anxiety,psychology,and social interaction in the experimental group were higher than those in the control group[(71.0±11.5)points vs.(49.1±10.3)points,(66.7±11.7)points vs.(45.4±10.5)points,(75.0±9.7)points vs.(56.4±8.5)points],with statistically significant differences(P<0.01 for all);in terms of postoperative function,the score for eating in the experimental group was higher than that in the control group[(83.4±10.7)points vs.(71.0±14.9)points](P<0.01),but there were no statistically significant differences in the other three indicators(P>0.05 for all);in terms of adverse reaction,there was no statistically significant difference between the two groups(P>0.05).ConclusionThe result of the FACE-Q questionnaire assessment confirmed that robot-assisted mandibular angle osteotomy can significantly improve patients’postoperative appearance satisfaction,psychological state,social adaptability,and eating function without increasing the incidence of complications.