Retrospective Assessment of Patient Satisfaction After Orthognathic Surgery
Retrospective Assessment of Patient Satisfaction After Orthognathic Surgery
Kenneth M. Kufta, BS1,2,3; Zachary S. Peacock, MD, DMD1,3; Sung-Kiang Chuang, MD, DMD, DMSc1,3; Lawrence M. Levin, MD, DMD2
1Harvard School of Dental Medicine; 2Hospital of the University of Pennsylvania; 3Massachusetts General Hospital
Orthognathic correction of dentofacial deformities can have a dramatic effect on a patient's life with potential for improvements in function and appearance. After orthognathic surgery, patients have been reported to be dissatisfied with biting (62%), chewing (55%), numbness (53%), and facial swelling (34%).1 Patients are nearly 8 times more likely to be satisfied when others have noticed a change in appearance. 2 Few other data exists on what particular changes are related to overall satisfaction. Postoperative patient satisfaction studies provide opportunities to improve communication with the patient prior to the operation and tailor treatment to match expectations.
The purpose of this study was to compare overall patient satisfaction with specific categories of satisfaction: (1) appearance, (2) functional abilities, (3) general health, (4) sociability, and (5) patient-clinician communication after orthognathic surgery. Patients were included if they had undergone a Le Fort I osteotomy, a bilateral sagittal split osteotomy, or both and at least 6 months of follow-up. Patients with craniofacial syndromes or those undergoing distraction osteogenesis, or condylar reconstruction were excluded.
A 16-question survey was developed and administered to included subjects at the University of Pennsylvania and Massachusetts General Hospital since June 2013. Demographic and predictor variables were the following: age, gender, surgical procedure undergone, smoking history, previous diagnoses of sleep apnea/asthma/other respiratory problems, psychiatric disorder, and post-operative infection or paresthesia. The outcome variable was patient satisfaction in each category based on a Likert scale (0, not satisfied at all to 5, very satisfied).
Descriptive statistics were computed for all of the study variables and the Spearman correlation (ρ) among variables was investigated. A correlational analysis was developed to identify study variables that were associated with changes in overall satisfaction outcome.
Twenty-one patients have completed the survey thus far and had a high overall rate of satisfaction (100% of responses were 4 or 5 on Likert scale). Overall satisfaction had the highest correlation with appearance (ρ = 0.51544, p = 0.0168). Other categories were correlated as follows: functionality (ρ = 0.20253, p = 0.3786), general health (ρ = -0.31964, p = 0.1578), sociability (ρ = 0.30824, p = 0.174), and patient-clinician communication (ρ = 0.21504, p = 0.3492).
Satisfaction with functionality (ρ = 0.20253, p = 0.3786) was less important to overall satisfaction than appearance; however, satisfaction with appearance is correlated with that of function (ρ = 0.48308, p = 0.0265). This suggests that overall satisfaction with the procedure is highly dependent upon improvement in function and appearance. Final results could help surgeons better address patient expectations that are important in producing high patient satisfaction.
References
1. Phillips, C. et al. J. Oral. Maxillofac. Surg. Perceptions of Recovery and Sa/sfac/on in the Short Term AZer Orthognathic Surgery. 2004. 535-544.
2. Trovik, TA. et al. Am J Orthod Dentofacial Orthop. Patients' perceptions of improvements after bilateral sagittal split osteotomy advancement surgery: 10 to 14 years of follow-up. 2012. 204-212.