Psychosocial Impact of Facial Disfigurement from Untreated Ameloblastoma on Patient Wellbeing in Plateau State: A Mixed-Methods Study

Ameloblastoma is the most common odontogenic tumor in sub-Saharan Africa and frequently presents with gross facial enlargement due to late diagnosis, particularly in communities with limited access to specialist surgical care. The psychosocial consequences of such disfigurement, including social withdrawal, depression, reduced economic participation, and stigmatization, are poorly quantified in the Nigerian context. This mixed-methods study investigates the psychosocial impact of facial disfigurement from untreated ameloblastoma on patient wellbeing and community participation in Plateau State, North Central Nigeria. The quantitative component involved administration of the Derriford Appearance Scale (DAS-59) and the Patient Health Questionnaire-9 (PHQ-9) to 44 ameloblastoma patients awaiting surgery at Jos University Teaching Hospital. The qualitative component comprised in-depth interviews with 16 patients exploring lived experiences of stigma, employment impact, family relationships, and healthcare-seeking journeys. Quantitative findings reveal significant appearance-related distress in 75% of participants, with moderate to severe depressive symptoms in 38%. Qualitative themes include social exclusion from community events, abandonment by spouses, and inability to work due to stigmatization. Most participants had lived with visible facial swelling for more than three years before presentation to a specialist. The study underscores the imperative for early surgical intervention and psychosocial support for ameloblastoma patients, and recommends the incorporation of mental health assessment into the preoperative evaluation framework at North Central hospitals. Keywords: ameloblastoma, facial disfigurement, psychosocial impact, Plateau State, stigma.