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Effect of temporal bone resection on temporomandibular joint function: a quality of life study
Carmen de Casso1, Sadie Kwhaja, Stephen Davies
1University Department of Otolaryngology, Head and Neck Surgery, Manchester Royal Infirmary, Manchester, UK. cdecasso@doctors.org.uk
Objectives:
Temporal bone resection for carcinoma may affect quality of life (QOL) and result in temporomandibular joint (TMJ) disorders. The aims of this study were to 1) assess TMJ function after temporal bone resection, and 2) assess the impact of TMJ dysfunction on QOL.
Study Design:
Chart and patient review and QOL study.
Setting:
Tertiary referral center (Manchester Royal Infirmary).
Subjects And Methods:
Thirty patients who had undergone temporal bone resection were identified. Thirteen patients were alive and were included in the study. All patients were submitted to a clinical examination to identify TMJ disorders and determine facial nerve function, and they all answered the University of Washington QOL (UW-QOL) questionnaire (version 4).
Results:
Eight patients had TMJ disorders with reduced mobility in either direction and/or significant pain. Main factors affecting QOL were pain (P = 0.001), appearance (P = 0.001), and anxiety (P = 0.000). Neither facial nerve palsy nor TMJ disorders affected QOL. The responses to the UW-QOL questionnaire showed that 69 percent of our patients had a good QOL. A total of 61.53 percent of our patients had TMJ dysfunction presenting as restriction of jaw mobility with or without pain.
Conclusion:
TMJ dysfunction is present in a significant number of patients after temporal bone resection, resulting in longstanding problems, which should be addressed accordingly. Poor QOL results from ongoing pain and psycho-social disturbance.
