Recovery after orthognathic surgery: short-term health-related quality of life outcomes

Abstract

Purpose: The purpose of this study was to assess the patient-reported time to recovery for quality of life outcomes: postsurgery sequelae, discomfort/pain, oral function, and daily activities after orthognathic surgery.

Patients and methods: A total of 170 patients (age = 14-53) were enrolled in a prospective study before orthognathic surgery. Each patient was given a 20-item health-related quality of life instrument (OSPostop) to be completed each postsurgery day (PSD) for 90 days. The instrument was designed to assess patients' perception of recovery for 4 domains: postsurgery sequelae, discomfort/pain, oral function, and daily activities. Discomfort/pain was recorded with a 7-point Likert-type scale; all other items were measured on a 5-point Likert-type scale.

Results: Postsurgery sequelae, except swelling, resolved within the first week after surgery for over 75% of the subjects. Discomfort/pain and medication usage persisted for 2 to 3 weeks after surgery for most subjects. Return to usual activities, except for recreational activities, which took substantially longer, mirrored the resolution of discomfort/pain. Problems with oral function took the longest to resolve, approximately 6 to 8 weeks for the majority of subjects.

Conclusion: Comprehensive daily postoperative patient quality of life data provides the orthognathic surgeon with estimated recovery times in distinct domains. This information is vital in the provision of informed consent as well as preoperative education of patients regarding perioperative and postoperative expectations. Ultimately this data can be combined with individual risk factors to provide personalized consent and expectations as well as tailor perioperative and postoperative management regimens.

Figure 1

Descriptive Statistics for the Number of Days until Recovery (No or Only Slight Trouble or Concern) from Peri-operative Sequelae

Figure 2

Percentage of Patients Each Day who Reported a Substantial Problem associated with Peri-operative Sequelae 2A: Nausea, Bruising, Food Collection 2B: Bad Breath, Swelling

Figure 2

Percentage of Patients Each Day who Reported a Substantial Problem associated with Peri-operative Sequelae 2A: Nausea, Bruising, Food Collection 2B: Bad Breath, Swelling

Figure 3

Descriptive Statistics for the Number of Days until No or Only Slight Discomfort was Reported and until Medication for Pain or Discomfort was Discontinued.

Figure 4

Percentage of Patients Each Day who Reported a Substantial Problem associated with Discomfort / Pain

Figure 5

Percentage of Patients who Reported Taking a Narcotic or Non-Narcotic Analgesic Each Day for Discomfort / Pain

Figure 6

Descriptive Statistics for the Number of Days until No Trouble or Concern was Reported for Participating in Daily Activities

Figure 7

Percentage of Patients Each Day who Reported a Substantial Problem Participating in Daily Activities

Figure 8

Descriptive Statistics for the Number of Days until No Trouble or Concern with Oral Function was Reported

Figure 9

Percentage of Patients Each Day who Reported a Substantial Problem with Oral Function