Prognostic factors, symptom evolution, and quality of life of posttraumatic trigeminal neuropathy

Fréderic Van der Cruyssen, Frederik Peeters, Antoon De Laat, Reinhilde Jacobs, Constantinus Politis, Tara Renton, Fréderic Van der Cruyssen, Frederik Peeters, Antoon De Laat, Reinhilde Jacobs, Constantinus Politis, Tara Renton

Abstract

Neurosensory disturbances (NSDs) caused by injury to the trigeminal nerve can affect many aspects of daily life. However, factors affecting the persistence of NSDs in patients with posttraumatic trigeminal neuropathies (PTTNs) remain largely unknown. The identification of such risk factors will allow for the phenotyping of patients with PTTNs, which is crucial for improving treatment strategies. We therefore aimed to identify the prognostic factors of NSD persistence, pain intensity, and quality of life (QoL) in patients with PTTNs and to use these factors to create a prognostic prediction model. We first performed a bivariate analysis using retrospective longitudinal data from 384 patients with NSDs related to posttraumatic injury of the trigeminal nerve (mean follow-up time: 322 ± 302 weeks). Bivariate and multivariate analyses were performed. The multivariable prediction model to predict persistent NSDs was able to identify 76.9% of patients with persistent NSDs, with an excellent level of discrimination (area under the receiver operating characteristic curve: 0.84; sensitivity: 81.8%; specificity: 70.0%). Furthermore, neurosensory recovery was significantly associated with sex; injury caused by local anesthesia, extraction, third molar surgery, or endodontic treatment; and the presence of thermal hyperesthesia. Pain intensity and QoL analysis revealed several factors associated with higher pain levels and poorer QoL. Together, our findings may aid in predicting patient prognosis after dental, oral, and maxillofacial surgery and might lead to personalized treatment options and improved patient outcomes.

Trial registration: ClinicalTrials.gov NCT04612855.

Conflict of interest statement

The authors have no conflicts of interest to declare.

Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Association for the Study of Pain.

Figures

Figure 1.
Figure 1.
Kaplan–Meier analysis of neurosensory disturbances (NSDs) over time comparing sex (A), age (B), painful and nonpainful posttraumatic trigeminal neuropathies (PTTNs) (C), initiating event (D), injured nerve branch (E), and sensory profile (F). Between-group pairwise comparisons were all statistically significant (P < 0.0005, pairwise log-rank test).

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