ABSTRACT
STATEMENT OF PROBLEM: A maxillofacial prosthesis represents an effective method of giving maxillofacial defects a positive esthetic appearance with minimal risk. However, studies of complications among prosthesis wearers are lacking. PURPOSE: The purpose of this cross-sectional study was to determine levels of patient satisfaction with various maxillofacial prostheses and retention types, as measured through a survey questionnaire package. MATERIAL AND METHODS: Patients treated at the Sunnybrook Health Sciences Center Craniofacial Prosthetics Unit (CPU) since 2015 were included. They had been treated according to a standardized protocol and answered a survey questionnaire package with the following sections: demographics, frequency of prosthesis usage, and the Toronto Outcome Measure for Craniofacial Prosthetics (TOMCP-27) survey addressing patient satisfaction. To be eligible for this study, patients must have been more than 18 years of age, in possession of a maxillofacial prosthesis, and received treatment at the Sunnybrook Health Sciences Center CPU since 2015. RESULTS: A total of 157 patients were eligible and contacted, of whom 51 agreed to participate in the survey. The study population was overall extremely satisfied with their maxillofacial prostheses. In 77.8% of the TOMCP-27 questions, the largest group of patients chose the answer demonstrating the highest level of satisfaction. Of all prosthesis types surveyed, patients with auricular prostheses reported the greatest rates of satisfaction, with the entire group having selected answers corresponding to the highest levels of overall satisfaction. However, patients with orbital prostheses were more likely to experience varying degrees of dissatisfaction, with 72% of the highest reported levels of dissatisfaction being from this prosthesis group. In addition, patients with osseointegrated implant-retained prostheses reported higher satisfaction levels with other retention methods, with the bar clasp group outperforming the magnetic coupling retention group. CONCLUSIONS: Patients experienced an excellent overall rate of satisfaction with their maxillofacial prostheses. Future development should focus on the continued development of osseointegrated methods, improved magnetic coupling, and improved prosthesis technology, especially for orbital prostheses.
ABSTRACT
BACKGROUND: Despite the abundance of coronary chronic total occlusions (CTO) percutaneous coronary intervention (PCI) studies, the literature is not easy to digest for both general PCI operators and CTO PCI specialists because of the many varied terms used for approaches and inconsistency in terminology. This inconsistency makes it challenging to understand the advantages and disadvantages of these different approaches and, most importantly, their downstream clinical outcomes. Accordingly, we conducted a systematic review of all published studies on CTO PCI to describe techniques and algorithms used in the last decade to provide an overview on the efficacy and safety of contemporary CTO PCI techniques. METHODS: We performed a comprehensive search of the PubMed, EMBASE, and the Cochrane library databases for manuscripts about PCI of CTOs. We included studies published between the years 2005 and 2019. We categorized studies into those using a single approach (antegrade, retrograde) and those with a prespecified algorithm (ie, hybrid approach). RESULTS: Fifty-five observational studies including 28,907 patients who underwent CTO were included in this review. CTO PCI generally carries low risk of major procedural complications, with angiographic success rates being higher in studies that used an algorithmic vs single technical approach. CONCLUSIONS: This systematic review highlights the wide variation in definitions and practices in CTO PCI and calls for standardization in terminology and practice.
CONTEXTE: Malgré l'abondance d'études sur l'intervention coronarienne percutanée (ICP) en cas d'occlusion totale chronique (OTC), la littérature n'est pas facile à assimiler, tant pour les opérateurs généraux qui effectuent des ICP que pour les spécialistes des ICP en cas d'OTC, en raison des nombreux termes utilisés pour les approches et de l'incohérence sur le plan de la terminologie. Cette incohérence rend difficile la compréhension des avantages et des inconvénients de ces différentes approches et, surtout, de leurs résultats cliniques en aval. Nous avons donc procédé à une revue systématique de toutes les études publiées sur l'ICP en cas d'OTC afin de décrire les techniques et les algorithmes utilisés au cours de la dernière décennie et de donner un aperçu de l'efficacité et de l'innocuité des techniques contemporaines d'ICP en cas d'OTC. MÉTHODOLOGIE: Nous avons effectué une recherche exhaustive dans les bases de données PubMed, EMBASE et Cochrane Library pour trouver des articles sur l'ICP en cas d'OTC. Nous avons retenu les études publiées entre 2005 et 2019. Nous avons classé ces études en deux catégories : celles qui utilisent une seule approche (antérograde, rétrograde) et celles qui utilisent un algorithme prédéfini (approche hybride). RÉSULTATS: Cette revue portait sur 55 études observationnelles, pour un total de 28 907 patients présentant des OTC. L'ICP en cas d'OTC comporte généralement un faible risque de complications importantes liées aux interventions, les taux de réussite angiographique étant plus élevés pour les études où une approche algorithmique était utilisée que pour celles où l'on recourait à une approche technique unique. CONCLUSIONS: Cette revue systématique souligne la grande variation des définitions et des pratiques en matière d'ICP en cas d'OTC, ainsi que le besoin d'une normalisation de la terminologie et de la pratique.
