背景:在COVID-19大流行爆发后,远程医疗已迅速应用于医疗和牙科实践。虽然在类似的口腔医学和神经病学领域已经描述了通过远程医疗进行检查的指南,对有口面疼痛症状的患者进行全面远程医疗检查的框架尚未描述。
目的:本研究的目的是介绍对新的口面疼痛患者进行远程医疗检查的格式,并描述远程医疗咨询在医院口面疼痛实践中的成功和实用性。
方法:对2020年4月2日至2021年3月29日所有新的远程医疗咨询进行了回顾性审查。对病历进行了审查,以了解患者的人口统计信息以及初始远程医疗咨询和办公室随访的详细信息。
结果:共发现二百七十例新患者。最常见的诊断是咀嚼肌的肌筋膜疼痛(37%),TMJ的关节盘疾病(21%),和TMJ关节痛(16%),其次是阻塞性睡眠呼吸暂停(9%)和神经性口面部疼痛(6%)。146名患者返回诊所进行办公室随访,其中78.8%有准确的远程医疗诊断。难以辨别咀嚼性肌筋膜疼痛和TMJ关节痛是远程医疗诊断中不准确的最常见原因。
结论:口面部疼痛患者的远程医疗咨询有助于促进准确诊断,并加快面临办公室咨询挑战的患者的治疗。
BACKGROUND: Following the onset of the COVID-19 pandemic, telemedicine has become rapidly implemented into both medical and dental practices. While
guidelines for examination through telemedicine have been described in similar fields of oral medicine and neurology, the framework for a comprehensive telemedicine examination for a patient with symptoms of orofacial pain has not yet been described.
OBJECTIVE: The objective of this study is to introduce the format of a telemedicine examination for a new patient with orofacial pain as well as describe the success and utility of a telemedicine consultation in a hospital-based orofacial pain practice.
METHODS: A retrospective review was performed of all new telemedicine consults from April 2, 2020, to March 29, 2021. Medical records were reviewed for patient demographics as well as details of the initial telemedicine consult and in-office follow up.
RESULTS: Two hundred seventy new patients were seen. The most common diagnoses were myofascial pain of the masticatory muscles (37%), an articular disc disorder of the TMJ (21%), and TMJ arthralgia (16%), followed by obstructive sleep apnea (9%) and neuropathic orofacial pain (6%). 146 patients returned to the clinic for an in-office follow up, 78.8% of which had an accurate telemedicine diagnosis. Difficulty discerning between masticatory myofascial pain and TMJ arthralgia was the most common reason for inaccuracy during the telemedicine diagnosis.
CONCLUSIONS: Telemedicine consultation for patients with orofacial pain can help facilitate an accurate diagnosis and expedite treatment for patients who face challenges presenting for an in-office consultation.