The psychosocial and affective burden of posttraumatic neuropathy following injuries to the trigeminal nerve

J Orofac Pain. 2013 Fall;27(4):293-303. doi: 10.11607/jop.1056.

Abstract

Aims: To explore the impact of trigeminal nerve injuries on quality of life, including the effect of pain on psychological and affective function.

Methods: An observational, cross-sectional survey design was employed. Fifty-six patients with inferior alveolar nerve injury (IANI) and 33 patients with lingual nerve injury (LNI) completed standardized self-report measures of pain intensity, pain catastrophizing, self-efficacy to cope with pain, and mood, in addition to generic and oral health-related quality of life (HRQoL) indicators. The impact of pain severity on these aspects of psychosocial function was examined. Summary statistics were calculated for all measures and compared with norms or values of other relevant studies, when available, using t tests. The impact of pain severity on these aspects of psychosocial function was examined using analysis of variance and hierarchical multivariate regression models.

Results: The majority of patients reported pain associated with their nerve injury (86%). Nerve injury had a significant impact on all investigated domains, and this was closely linked with reported pain levels. Patients with severe pain showed particularly elevated levels of depression and pain catastrophizing, as well as substantially reduced HRQoL and coping efficacy levels. Pain intensity level was a significant predictor in all models except anxiety, uniquely contributing between 17% and 26% of variance to the prediction of pain catastrophizing, depression, coping efficacy, and generic and oral HRQoL.

Conclusion: Traumatic injury to the trigeminal nerve is associated with a substantial patient burden, particularly in patients who experience severe neuropathic pain as part of their condition. These findings highlight the need to identify, develop, and evaluate more effective treatments for neuropathic pain in trigeminal nerve injury that will not only provide clinically meaningful reductions in pain but also improve patients' quality of life.

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Analysis of Variance
  • Catastrophization
  • Cross-Sectional Studies
  • Dental Care / adverse effects*
  • Depression
  • Female
  • Humans
  • Iatrogenic Disease
  • Lingual Nerve Injuries / etiology
  • Lingual Nerve Injuries / psychology*
  • Male
  • Mandibular Nerve / physiopathology*
  • Middle Aged
  • Neuralgia / psychology
  • Pain Management
  • Psychology
  • Quality of Life*
  • Regression Analysis
  • Self Efficacy
  • Self Report
  • Stress Disorders, Post-Traumatic / etiology
  • Stress Disorders, Post-Traumatic / psychology*
  • Trigeminal Nerve Injuries / etiology
  • Trigeminal Nerve Injuries / psychology*