Cardinaal, M.M.B. (2022) Patiënttevredenheid over conservatief behandelde sinus frontalis fracturen en de invloed van de objectiveerbare eigenschappen van de fractuur. thesis, Dentistry.
Full text available on request.Abstract
Frontal sinus fractures can be treated conservatively and surgically. Conservative treatment is possible if the drainage of the sinus has remained intact and the fractured bone parts are slightly dislocated, so that only a limited impression is present. Knowledge is lacking about patient satisfaction of conservatively treated fractures and their cosmetic consequences. This gap in knowledge may lead to overtreatment, potentially resulting in redundant surgery with a scar, or undertreatment, potentially resulting in decreased patient satisfaction due to a visible dent. To avoid this, insight is necessary into the patients’ satisfaction with their appearance of their forehead, appearance of the face in general, social functioning and psychological well-being during conservative treatment and their relationship with objectifiable properties of a frontal sinus fracture. The research question in this study was formulated as follows: ‘How does the degree of satisfaction with the aesthetics of the forehead of patients with a conservatively treated frontal sinus fracture compare to people without a fracture?’. This research also examines the sub-question ‘How does the degree of satisfaction in a conservatively treated fracture relate to the objectifiable properties of the fracture of the anterior wall of the frontal sinus?’. The aim of this case-control study is to provide surgeons with guidance in making a decision for a type of treatment that will be most satisfying to the patient with regard to aesthetics; conservative or surgical treatment of a frontal sinus fracture. The study population was selected from a patient series of all patients with facial trauma over the period 2010-2020. Conservatively treated patients, older than 15 years, with a fracture in the anterior wall of the frontal sinus were selected. For inclusion the sinus drainage system had to be intact, without signs of cerebrospinal fluid leakage. The control group consisted of subjects without fracture, also aged 15 years or older. The control group was determined by age and gender matching. Patient satisfaction was measured using the validated ‘Face Q questionnaire’. By means of a computed tomography scan (CT-scan) of the forehead, already performed for diagnostic purposes, the following objectifiable properties of the impression caused by the fracture were determined: length, width, deepest point, surface and greatest diagonal length of the fracture. From this, the length-width ratio, length-depth ratio, length-area ratio, width-depth ratio, width-area ratio and depth-area ratio were calculated. Information about any scars that may be present was obtained from an additional question in the questionnaire. The mean total score from the Face Q questionnaire in the group of patients with a conservatively treated frontal sinus fracture was 114.77 (SD = 17.38) and in the control group of patients without a fracture 114.23 (SD = 15.23). The mean difference in total score was 0.55 (SD = 4.85). This difference was not significant (p = 0.91). The area of the impression did not appear to have a linear relationship (p = 0.87, r = 0.00) with patient satisfaction within the entire population and was not included in the analysis. When analyzing the entire study population, the presence of a scar was found to be a significant predictor (p = 0,01) for patient satisfaction and explained 31% of the total score from the questionnaire. Within the group with a dislocated fracture, the presence of a scare in the area of the fracture was also a significant predictor (p = 0,003) for patient satisfaction and explained for 57% the total score from the questionnaire. Patients with a conservatively treated frontal sinus fracture and patients without a frontal sinus fracture have an equal patient satisfaction with the forehead. With a conservative management, a higher score in satisfaction can be related to the absence of a scar in a fracture of the anterior wall of the frontal sinus.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | van Minnen, Dr. B. |
| Faculty: | Medical Sciences |
| Date Deposited: | 17 Apr 2023 11:56 |
| Last Modified: | 17 Apr 2023 11:56 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3470 |
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