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Shamil E, Noriega M, Moin S, Ko TK, Tan DJY, Meller C, Andrews P, Lekakis G. Psychological Aspects of Facial Palsy. Facial Plast Surg 2024; 40:433-440. [PMID: 38648794 DOI: 10.1055/s-0044-1782678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
This article discusses the psychological effects of facial palsy (FP) in adults. FP is the abnormal functioning of facial muscles resulting from temporary or permanent damage of the facial nerves. Following facial paralysis, patients can develop motor and psychosocial functioning issues impacting quality of life. In addition, real or perceived judgment in social settings of those with FP increases the risk of low self-esteem, anxiety, and depression. Currently, most available research focuses on surgical patients and suggests a lack of psychological support throughout the affliction. A multidisciplinary approach when treating patients with FP can help improve the patient's quality of life.
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Affiliation(s)
- Eamon Shamil
- Department of ENT Surgery, Prince of Wales Hospital, Sydney, Australia
- Department of ENT Surgery, The Royal National ENT Hospital, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - Maria Noriega
- Department of ENT Surgery, The Royal National ENT Hospital, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - Sarah Moin
- Department of ENT Surgery, Hillingdon Hospitals NHS Foundation Trust, Uxbridge, United Kingdom
| | - Tsz Ki Ko
- Department of ENT Surgery, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
| | - Denise Jia Yun Tan
- Department of ENT Surgery, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
| | - Catherine Meller
- Department of ENT Surgery, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Peter Andrews
- Department of ENT Surgery, Royal National ENT and Eastman Dental Hospitals, London, United Kingdom
| | - Garyfalia Lekakis
- Department of ENT Surgery, Hôpitaux Iris Sud HIS, Brussels, Belgium
- University Hospitals Leuven, Leuven, BE, Louise Medical Center, Bruxelles, Belgium
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2
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Malik M, Khan RS, Shamil E. Ophthalmic Assessment and Management in Acute Facial Palsy. Facial Plast Surg 2024. [PMID: 38959970 DOI: 10.1055/a-2359-5280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024] Open
Abstract
This article aims to provide insights into emerging concepts in ophthalmic manifestations in patients with facial palsy and discusses considerations used to develop patient-specific management plans in acute management.
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Affiliation(s)
- Mohsan Malik
- Adnexal Service, Moorfields Eye Hospital, London, United Kingdom
| | - Raheej Shamim Khan
- Department of Occuloplastic, Machester Royal Eye Hospital, Oxford Rd, Manchester, United Kingdom
| | - Eamon Shamil
- Eamon Shamil FRCS (ORL-HNS), The Royal National ENT & Eastman Dental Hospital, University College London NHS Foundation Trust, Huntley Street, London, United Kingdom
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3
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Rostami S, Min S, McCann A, Sayers C, Samy R, Collar R, Hsieh TY. The Effectiveness of Facial Neuromuscular Retraining on Patients with Facial Nerve Dysfunction: A Mental Health and Quality of Life Analysis. Facial Plast Surg Aesthet Med 2024. [PMID: 38635958 DOI: 10.1089/fpsam.2023.0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024] Open
Abstract
Background: Facial muscle dysfunction can have drastic psychosocial effects. Objectives: To evaluate the impacts of customized neuromuscular retraining on mental health, quality of life (QoL), facial muscle function, and synkinesis. Methods: Thirty patients with facial nerve dysfunction completed a course of neuromuscular retraining. Patients' mental health, QoL, facial muscle function, and synkinesis were evaluated using Patient Health Questionnaire (PHQ-9), Facial Clinimetric Evaluation (FaCE) scale, electronic, clinician-graded facial function scale (eFACE), and Synkinesis Assessment Questionnaire (SAQ) at the initial and final visits. Scores were compared before and after treatment. Results: Patients (n = 30) included had a mean age of 59.4 ± 13.4 years (range 32.3-82.8) and were mostly female (22/30, 73.3%). The most common etiology was Iatrogenic facial nerve paralysis (11/20, 36.7%). Most patients had postfacial paralysis synkinesis (15/30, 50%), while 10 had complete flaccid paralysis. The median house-Brackmann score was 2 (range 1-6). The mean duration of facial palsy was 39.5 ± 106.9 (range 1-576 months). The duration of follow-up after the initial treatment session was 5.5 months, including 10 sessions. After neuromuscular retraining median PHQ-9 scores improved from 5 (range 0-25) to 3 (range 0-20) (p = 0.002). Mean FaCE PROM scores increased from 47.7 ± 11.5 to 56.5 ± 8.8 (p = 0.001). The mean eFACE score increased from 55.8 ± 15.1 to 71.7 ± 13.6 (p < 0.001). Median SAQ score was lower at the final visit (34.6 ± 13.4) compared to the initial visit (47.7 ± 17.8; p < 0.001). Conclusion: Customized neuromuscular retraining may improve patient-reported mental health, QoL, and facial muscle function and reduce synkinesis in facial nerve dysfunction.
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Affiliation(s)
- Sara Rostami
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Susie Min
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Adam McCann
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Colton Sayers
- Outpatient Rehabilitative Services Department, UCHealth, Cincinnati, Ohio, USA
| | - Ravi Samy
- Division of Otolaryngology/Head and Neck Surgery, Institute for Surgical Excellence, Lehigh Valley Health Network, Allentown, Pennsylvania, USA
| | - Ryan Collar
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Tsung-Yen Hsieh
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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van der Lely JN, Nieuwdorp NJ, Smits ICAW, van Zijl FVWJ, Corten EML, Mureau MAM. Quality of life after surgical treatments for facial palsy: A systematic review and meta-analysis. Head Neck 2024. [PMID: 38597121 DOI: 10.1002/hed.27772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/15/2024] [Accepted: 04/02/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Facial palsy profoundly affects patients' quality of life (QoL). We evaluated the effect of various surgical procedures on QoL using patient-reported outcome measures (PROMs) to provide evidence-based recommendations for improved care. METHODS Embase, Medline, Web of Science, Cochrane, and CINAHL were searched for studies on QoL in patients with facial palsy who had undergone reconstructive surgery with preoperative and postoperative data from validated PROMs. After conducting the quality assessment, data were subtracted from the articles. Meta-analyses of subgroups were performed when study outcomes where compatible. RESULTS Incorporating 24 studies (522 patients), our systematic review revealed consistent and significant QoL improvements following diverse reconstructive surgical procedures. CONCLUSIONS Our systematic review and meta-analysis showed the positive effects of different reconstructive surgical procedures on QoL of patients with facial palsy. These results support clinicians to better inform patients about their potential outcomes, optimizing informed and shared decision-making and ultimately improving overall QoL in patients with facial palsy.
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Affiliation(s)
- Johannes N van der Lely
- Department of Plastic & Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Niek J Nieuwdorp
- Department of Plastic & Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ineke C A W Smits
- Department of Otorhinolaryngology - Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Floris V W J van Zijl
- Department of Otorhinolaryngology - Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Eveline M L Corten
- Department of Plastic & Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marc A M Mureau
- Department of Plastic & Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Moritz WE, Volk GF, Kreysa H, Guntinas-Lichius O. Translation and validation of the German version of the FACE-Q paralysis module in adult patients with unilateral peripheral facial palsy. Sci Rep 2024; 14:7606. [PMID: 38556525 PMCID: PMC10982296 DOI: 10.1038/s41598-024-58159-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 03/26/2024] [Indexed: 04/02/2024] Open
Abstract
The aim was to develop and validate a German version of the FACE-Q paralysis module, a patient-reported outcome measure to assess health-related quality of life in adult patients with unilateral facial palsy. The FACE-Q craniofacial questionnaire, which includes the paralysis module, was translated. 213 patients with facial palsy completed the German FACE-Q paralysis along with the established FDI and FaCE questionnaires. Regression analyses were performed to examine the relationships between the different FACE-Q domains and patient and therapy characteristics. The FACE-Q scales had high internal consistency (Cronbach's alpha all > 0.6). High correlations were found between the FACE-Q and the FDI and FaCE (mean rho = 0.5), as well as within the FACE-Q (mean rho = 0.522). Unifactorial influences were found for all domains except Breathing (all p < 0.05). Multivariate independent predictors were found for some FACE-Q domains. Most influential predictors (> 8 subdomains): Patients who received physical therapy scored lower in ten subdomains than those who did not (all p < 0.05). Patients who had surgery scored lower in nine subdomains than patients without surgery (all p < 0.05). The German version of the FACE-Q Paralysis Module can now be used as a patient-reported outcome instrument in adult patients with facial nerve palsy.
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Affiliation(s)
- Wieta Elin Moritz
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Gerd Fabian Volk
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
- Facial-Nerve-Center, Jena University Hospital, Jena, Germany
- Center for Rare Diseases, Jena University Hospital, Jena, Germany
| | - Helene Kreysa
- Department for General Psychology and Cognitive Neuroscience, Friedrich Schiller University, Jena, Germany
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
- Facial-Nerve-Center, Jena University Hospital, Jena, Germany.
- Center for Rare Diseases, Jena University Hospital, Jena, Germany.
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Nowacka A, Barker-Collo S, Miles A. Exploring the influence of appearance evaluation apprehension: How fear of negative evaluation affects quality of life in people with Vestibular Schwannoma. J Clin Neurosci 2024; 123:7-12. [PMID: 38508019 DOI: 10.1016/j.jocn.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 03/22/2024]
Abstract
People diagnosed with Vestibular Schwannoma (VS) can experience several symptoms both pre and post-treatment. These, alongside the diagnosis experience, can significantly impact their daily life. The present research is a continuation of a larger study aiming to explore the impacts of symptomology and body image/fear of negative evaluation (FNAE) on the quality of life (QOL) for people with VS. The research design was exploratory and involved a nationwide survey with a total of 52 participants. FNAE was assessed using a measurement of the same name, and QOL was assessed using the Penn Acoustic Neuroma Quality of Life scale (PANQOL). Comparing management groups revealed a significant difference in FNAE with higher scores for surgery compared to radiation treatment. Regression analyses revealed that FNAE significantly accounted for 10.9% of the variance in QOL. However, no symptom was significantly predictive of FNAE. In conclusion, VS is associated with several symptoms that can persist post-treatment. Body satisfaction contributes to QOL and may differ between management types. However, due to inconclusive findings on the predictability of symptoms on FNAE, other moderator factors could influence these direct relationships. Future studies should evaluate the variables that could mitigate or protect from the impacts of FNAE for this population.
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Affiliation(s)
- Alicja Nowacka
- School of Psychology, The University of Auckland, Auckland, New Zealand.
| | - Suzanne Barker-Collo
- Clinical Training Programme, School of Psychology, The University of Auckland, Auckland, New Zealand
| | - Anna Miles
- Speech Science, School of Psychology, The University of Auckland, Auckland, New Zealand
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Altowayan RM, Alruwaysan SA, Alraddadi S, Alanazi MA, Alharbi S, Alobaid NM, Aldakhil LM, Almohaimeed AF, Alhomaid TA. Knowledge and Awareness Regarding Bell's Palsy in the Al-Qassim Region, Saudi Arabia. Cureus 2023; 15:e51327. [PMID: 38288216 PMCID: PMC10823306 DOI: 10.7759/cureus.51327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2023] [Indexed: 01/31/2024] Open
Abstract
Introduction: Bell's palsy, characterized by acute onset unilateral facial weakness, is caused by the paralysis of the seventh cranial nerve, which controls the muscles of the face. This condition can result in functional disabilities, and early detection and management are crucial for quick recovery. Awareness was found to be one of the factors associated with early detection and interventions. Therefore, this study aimed to assess the awareness of the population of Al-Qassim, Saudi Arabia, regarding Bell's palsy. METHODS We conducted a cross-sectional study on 1,198 participants in Al-Qassim, Saudi Arabia, between May and July 2023. We used a self-administered online questionnaire inquiring about knowledge and awareness of Bell's palsy. We performed descriptive and correlation analyses, and a p-value of less than 0.05 indicated a statistical significance. RESULTS The mean (± SD) knowledge score was 7.02 ± 2.03 out of a total of 13 points. Almost a third of participants (n=353, 29.5%) expressed uncertainty about the causes of Bell's palsy, with 346 (28.9%) and 107 (8.9%) attributing it to idiopathic factors and viral infections, respectively. Most participants (n=520, 43.4%) believed both genders were equally affected, while 563 (46.9%) correctly identified cranial nerve 7 as the affected nerve. Treatment awareness varied, with 629 (58.2%) acknowledging physiotherapy and (n=777, 64.9%) acknowledging traditional medicine. Interestingly, only 111 (9.3%) thought that Bell's palsy was permanent, most participants (n=1023, 85.4%) recognized Bell's palsy as treatable, and 1,105 (92.2%) correctly perceived it as non-contagious. There were significant correlations between awareness and age (p<0.001), gender (p<0.001), marital status (p<0.001), occupation (p<0.001), information source (p<0.001), nationality (p=0.009), and education levels (p<0.031). Addressing these gaps and demographic nuances through targeted educational campaigns is crucial for enhancing overall awareness of Bell's palsy. CONCLUSION These findings indicate suboptimal awareness among participants in general, poor knowledge about causes and clinical manifestation, and a relatively better awareness of treatments. We recommend further studies exploring awareness and associated factors.
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Affiliation(s)
- Ruba M Altowayan
- Unaizah College of Medicine and Medical Sciences, Qassim University, Qassim, SAU
| | - Samar A Alruwaysan
- Unaizah College of Medicine and Medical Sciences, Qassim University, Qassim, SAU
| | - Seba Alraddadi
- Unaizah College of Medicine and Medical Sciences, Qassim University, Qassim, SAU
| | | | - Seham Alharbi
- Unaizah College of Medicine and Medical Sciences, Qassim University, Qassim, SAU
| | - Njood M Alobaid
- Unaizah College of Medicine and Medical Sciences, Qassim University, Qassim, SAU
| | - Lama M Aldakhil
- Unaizah College of Medicine and Medical Sciences, Qassim University, Qassim, SAU
| | - Abdulaziz F Almohaimeed
- Department of Public Health, Department of Medicine and Surgery, King Fahad Specialist Hospital, Buraydah, SAU
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Dagenais F, Neville C, Desmet L, Martineau S. Measuring the Potential Effects of Mirror Therapy Added to the Gold Standard Facial Neuromuscular Retraining in Patients With Chronic Peripheral Facial Palsy: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e47709. [PMID: 37418307 PMCID: PMC10362495 DOI: 10.2196/47709] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/19/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Facial neuromuscular retraining (fNMR) is a noninvasive physical therapy widely used to treat peripheral facial palsies. It consists of different intervention methods that aim to reduce the debilitating sequelae of the disease. Recently, the use of mirror therapy in the acute facial palsy and postsurgical rehabilitation contexts has shown promising results, suggesting its use as an adjunct to fNMR in treating patients with later stages of paralysis, such as the paretic, early, or chronic synkinetic. OBJECTIVE The main aim of this study is to compare the efficacy of an added mirror therapy component with fNMR in patients with peripheral facial palsy (PFP) sequelae in 3 different stages. The specific objectives of this study are to measure the effects of combined therapy compared to fNMR alone on (1) participants' facial symmetry and synkinesis, (2) quality of life and psychological aspects of the participants, (3) motivation and treatment adherence, and (4) different stages of facial palsies. METHODS This study is a randomized controlled trial that compares the effect of fNMR combined with mirror therapy (experimental group: n=45) with fNMR alone (control group: n=45) in 90 patients with peripheral facial palsy presenting with sequelae 3-12 months after onset. Both groups will receive 6 months of rehabilitation training. Facial symmetry and synkinesis; participants' quality of life; and their psychological factors, motivation, and compliance will be assessed at baseline (T0), 3 months (T1), 6 months (T2), and 12 months (T3) postintervention. Outcome measures are (1) changes in facial symmetry and synkinesis assessed with facial grading tools, (2) quality of life changes with patient questionnaires, and (3) therapy motivation with a standardized scale, as well as adherence to treatment with metadata. Changes in facial symmetry and synkinesis will be judged by 3 assessors blinded to group assignment. Mixed models and Kruskal-Wallis, chi-square, and multilevel analyses will be conducted according to the appropriate variable type. RESULTS Inclusion will start in 2024 and is anticipated to be completed in 2027. The 12-month follow-up will be completed with the last patient in 2028. We expect patients included in this study to experience improvement in facial symmetry, synkinesis, and quality of life, regardless of group assignments. A potential benefit of mirror therapy for facial symmetry and synkinesis could be noted for patients in the paretic phase. We hypothesize better motivation and adherence to treatment for the mirror therapy group. CONCLUSIONS The results of this trial may provide new guidelines for PFP rehabilitation with patients dealing with long-term sequelae. It also fills the need for robust evidence-based data in behavioral facial rehabilitation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/47709.
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Affiliation(s)
| | - Catriona Neville
- Queen Victoria Hospital NHS Foundation Trust, East Grinstead, West Sussex, United Kingdom
| | - Liesbet Desmet
- Department of Health and Care, Artevelde University of Applied Sciences, Gent, Belgium
- European Institute for Otorhinolaryngology - Head & Neck Surgery, Sint-Augustinus GZA Hospital, Antwerp, Belgium
| | - Sarah Martineau
- Centre de Recherche de l'Hôpital Maisonneuve-Rosemont, École d'Orthophonie et d'Audiologie, Université de Montréal, Montreal, QC, Canada
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9
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Hasmat S, Low THH, Dusseldorp JR, Mukherjee P, Clark JR. Facial nerve palsy: Narrative review on the importance of the eye and its assessment. Head Neck 2022; 44:2600-2607. [PMID: 35894515 DOI: 10.1002/hed.27151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/25/2022] [Accepted: 07/07/2022] [Indexed: 11/12/2022] Open
Abstract
New solutions are emerging that address specific facial regions in facial nerve palsy (FNP). However the most dreaded consequence of FNP is paralytic lagophthalmos threatening the eye. A way to prioritize these regions is thus required. A review of the literature is conduced to capture the current concepts in evaluating FNP. Overall, patients are assessed from three perspectives: from the clinician's perspective using validated clinician-based grading instruments, from patient's perspective based on FNP-specific patient-reported outcome measures, and from the perspective of the layperson. The existing tools however provide limited information regarding the relative importance of different regions of the face. The eye appears to be an area of great concern for the patient where most surgical therapies are directed at. Addressing ocular problems in FNP carry a high priority but this is not clearly reflected by the standard systems.
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Affiliation(s)
- Shaheen Hasmat
- Faculty of Medicine, University of Sydney, Camperdown, New South Wales, Australia.,Sydney Facial Nerve Service, The Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Tsu-Hui Hubert Low
- Faculty of Medicine, University of Sydney, Camperdown, New South Wales, Australia.,Sydney Facial Nerve Service, The Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Joseph R Dusseldorp
- Faculty of Medicine, University of Sydney, Camperdown, New South Wales, Australia.,Sydney Facial Nerve Service, The Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Payal Mukherjee
- Faculty of Medicine, University of Sydney, Camperdown, New South Wales, Australia.,Sydney Facial Nerve Service, The Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Jonathan R Clark
- Faculty of Medicine, University of Sydney, Camperdown, New South Wales, Australia.,Sydney Facial Nerve Service, The Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
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10
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Pinkiewicz M, Dorobisz K, Zatoński T. A Comprehensive Approach to Facial Reanimation: A Systematic Review. J Clin Med 2022; 11:jcm11102890. [PMID: 35629016 PMCID: PMC9143601 DOI: 10.3390/jcm11102890] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/08/2022] [Accepted: 05/18/2022] [Indexed: 02/04/2023] Open
Abstract
Purpose: To create a systematic overview of the available reconstructive techniques, facial nerve grading scales, physical evaluation, the reversibility of paralysis, non-reconstructive procedures and medical therapy, physical therapy, the psychological aspect of facial paralysis, and the prevention of facial nerve injury in order to elucidate the gaps in the knowledge and discuss potential research aims in this area. A further aim was to propose an algorithm simplifying the selection of reconstructive strategies, given the variety of available reconstructive methods and the abundance of factors influencing the selection. Methodological approach: A total of 2439 papers were retrieved from the Medline/Pubmed and Cochrane databases and Google Scholar. Additional research added 21 articles. The primary selection had no limitations regarding the publication date. We considered only papers written in English. Single-case reports were excluded. Screening for duplicates and their removal resulted in a total of 1980 articles. Subsequently, we excluded 778 articles due to the language and study design. The titles or abstracts of 1068 articles were screened, and 134 papers not meeting any exclusion criterion were obtained. After a full-text evaluation, we excluded 15 papers due to the lack of information on preoperative facial nerve function and the follow-up period. This led to the inclusion of 119 articles. Conclusions: A thorough clinical examination supported by advanced imaging modalities and electromyographic examination provides sufficient information to determine the cause of facial palsy. Considering the abundance of facial nerve grading scales, there is an evident need for clear guidelines regarding which scale is recommended, as well as when the postoperative evaluation should be carried out. Static procedures allow the restoral of facial symmetry at rest, whereas dynamic reanimation aims to restore facial movement. The modern approach to facial paralysis involves neurotization procedures (nerve transfers and cross-facial nerve grafts), muscle transpositions, and microsurgical free muscle transfers. Rehabilitation provides patients with the possibility of effectively controlling their symptoms and improving their facial function, even in cases of longstanding paresis. Considering the mental health problems and significant social impediments, more attention should be devoted to the role of psychological interventions. Given that each technique has its advantages and pitfalls, the selection of the treatment approach should be individualized in the case of each patient.
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11
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Wihlidal JG, Bysice A, Rammal A, Yoo J, Matic D, Mendez A. Thematic Analysis of Canadian Patient-Reported Outcomes in Facial Nerve Paralysis: A Combined Interpretive Description and Modified Delphi Approach. Facial Plast Surg Aesthet Med 2022; 24:453-459. [DOI: 10.1089/fpsam.2021.0325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jacob G.J. Wihlidal
- Department of Otolaryngology—Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Andrew Bysice
- Department of Otolaryngology—Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Almoaidbellah Rammal
- Department of Otolaryngology—Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Canada
- Department of Otorhinolaryngology—Head and Neck Surgery, King Abdul-Aziz University, Jeddah, Saudi Arabia
- Department of Medicine, King Abdul-Aziz University, Jeddah, Saudi Arabia
| | - John Yoo
- Department of Otolaryngology—Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Damir Matic
- Department of Plastic and Reconstructive Surgery, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Adrian Mendez
- Department of Otolaryngology—Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Canada
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12
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Pavese C, Giordano A, Toffola ED, Nardone A, Franchignoni F. The Facial Disability Index in adults with peripheral facial palsy: Rasch analysis and suggestions for refinement. Arch Phys Med Rehabil 2021; 103:1544-1550. [PMID: 34902338 DOI: 10.1016/j.apmr.2021.10.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 10/13/2021] [Accepted: 10/21/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the psychometric properties of the validated Italian version of the Facial Disability Index (FDI), a patient-reported outcome measure widely used to assess individuals with peripheral facial palsy. DESIGN Methodological research on cross-sectional data from a convenience sample. SETTING Outpatient university rehabilitation clinic. PARTICIPANTS One hundred and eighty-six outpatients (66% females; mean age 44±15 years) with peripheral facial palsy of diverse etiology (48% post-surgical, 31% Bell's palsy, 8% post-traumatic, 3% congenital, 11% other medical conditions) and severity at the first visit. INTERVENTIONS Not applicable MAIN OUTCOME MEASURES: The two FDI subscales - physical function (FDI-PHY) and social/well-being function (FDI-SWB) - were separately analyzed using Classical Test Theory methods and Rasch analysis. RESULTS Cronbach's alpha was 0.79 in FDI-PHY and 0.74 in FDI-SWB, while item-rest correlation ranged from 0.36 to 0.67 in FDI-PHY, and from 0.43 to 0.68 in FDI-SWB. In the FDI-PHY, we deleted two underused response categories, rescoring the remaining ones. In the FDI-SWB, some response categories did not function as expected by the Rasch model: their collapse into a 4-level format solved this problem. In each subscale, all items fitted the Rasch model except item #4 (eye tearing/becoming dry) in FDI-PHY that showed an unexpectedly high response variability. The person separation reliability of both subscales indicated that they are useful only for group-level judgments. In both subscales, Principal Component Analysis of the residuals showed unidimensionality and absence of locally dependent items. No significant Differential Item Functioning concerning gender, age, or time from paralysis emerged. CONCLUSIONS Our study demonstrated overall positive psychometric characteristics of FDI except for the functioning of the response categories. We propose a refined version (r-FDI) with four response categories only and related conversion graphs that may improve the interpretability, feasibility and metric performance of this tool.
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Affiliation(s)
- Chiara Pavese
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy. Via Alessandro Brambilla, 74, 27100 Pavia, Italy; Neurorehabilitation and Spinal Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy. Via Salvatore Maugeri, 10, 27100 Pavia, Italy.
| | - Andrea Giordano
- Bioengineering Unit, Istituti Clinici Scientifici Maugeri IRCCS, Veruno (NO), Italy. Via Revislate, 13, 28010 Veruno (NO), Italy.
| | - Elena Dalla Toffola
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy. Via Alessandro Brambilla, 74, 27100 Pavia, Italy; Physical Medicine and Rehabilitation Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. Viale Camillo Golgi 19, 27100 Pavia, Italy.
| | - Antonio Nardone
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy. Via Alessandro Brambilla, 74, 27100 Pavia, Italy; Neurorehabilitation and Spinal Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy. Via Salvatore Maugeri, 10, 27100 Pavia, Italy.
| | - Franco Franchignoni
- Physical and RehabilitationMedicine Unit, Istituti Clinici Scientifici Maugeri IRCCS, Tradate (VA), Italy. Via Roncaccio, 16, 21049 Tradate (Va), Italy.
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Klassen AF, Rae C, Wong Riff KW, Bulstrode N, Denadai R, Goldstein J, Hol ML, Murray DJ, Bracken S, Courtemanche DJ, O'Hara J, Butler D, Tassi A, Malic CC, Ganske IM, Phua YS, Marucci DD, Johnson D, Swan MC, Breuning EE, Goodacre TE, Pusic AL, Cano S. FACE-Q Craniofacial Module: Part 1 validation of CLEFT-Q scales for use in children and young adults with facial conditions. J Plast Reconstr Aesthet Surg 2021; 74:2319-2329. [PMID: 34274246 DOI: 10.1016/j.bjps.2021.05.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 02/09/2021] [Accepted: 05/27/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND The CLEFT-Q includes 12 independently functioning scales that measure appearance (face, nose, nostrils, teeth, lips, jaws), health-related quality of life (psychological, social, school, speech distress), and speech function, and an eating/drinking checklist. Previous qualitative research revealed that the CLEFT-Q has content validity in noncleft craniofacial conditions. This study aimed to examine the psychometric performance of the CLEFT-Q in an international sample of patients with a broad range of facial conditions. METHODS Data were collected between October 2016 and December 2019 from 2132 patients aged 8 to 29 years with noncleft facial conditions. Rasch measurement theory (RMT) analysis was used to examine Differential Item Function (DIF) by comparing the original CLEFT-Q sample and the new FACE-Q craniofacial sample. Reliability and validity of the scales in a combined cleft and craniofacial sample (n=4743) were examined. RESULTS DIF was found for 23 CLEFT-Q items when the datasets for the two samples were compared. When items with DIF were split by sample, correlations between the original and split person locations showed that DIF had negligible impact on scale scoring (correlations ≥0.995). In the combined sample, RMT analysis led to the retention of original content for ten CLEFT-Q scales, modification of the Teeth scale, and the addition of an Eating/Drinking scale. Data obtained fit with the Rasch model for 11 scales (exception School, p=0.04). Person Separation Index and Cronbach alpha values met the criteria. CONCLUSION The scales described in this study can be used to measure outcomes in children and young adults with cleft and noncleft craniofacial conditions.
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Affiliation(s)
- Anne F Klassen
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
| | - Charlene Rae
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
| | - Karen Wy Wong Riff
- Department of Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
| | - Neil Bulstrode
- Division of Plastic and Reconstructive Surgery, Great Ormond Street Hospital, London, UK.
| | - Rafael Denadai
- Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, Sao Paulo , Brazil.
| | - Jesse Goldstein
- Department of Plastic Surgery, Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
| | - Marinka Lf Hol
- Department of Otolaryngocoloy and Head and Neck Surgery, University Medical Center Utrecht, Prinses Maxima Center for Childhood oncology, Utrecht, The Netherlands.
| | - Dylan J Murray
- National Paediatric Craniofacial Centre, Children's Health Ireland at Temple Street, Dublin, Ireland.
| | - Shirley Bracken
- National Paediatric Craniofacial Centre, Children's Health Ireland at Temple Street, Dublin, Ireland.
| | | | - Justine O'Hara
- Division of Plastic and Reconstructive Surgery, Great Ormond Street Hospital, London, UK.
| | - Daniel Butler
- Division of Plastic and Reconstructive Surgery, Great Ormond Street Hospital, London, UK.
| | - Ali Tassi
- Division of Graduate Orthodontics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
| | - Claudia C Malic
- Department of Surgery, Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada.
| | - Ingrid M Ganske
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA.
| | - Yun S Phua
- Department of Plastic and Reconstructive Surgery, Queensland Children's Hospital, Brisbane, Australia.
| | - Damian D Marucci
- The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia.
| | - David Johnson
- Oxford Craniofacial Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
| | - Marc C Swan
- Spires Cleft Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
| | - Eleonore E Breuning
- Department of Plastic Surgery, Alder Hey Children's Hospital, Liverpool, United Kingdom.
| | - Tim Ee Goodacre
- Spires Cleft Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
| | - Andrea L Pusic
- Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital, Boston, MA, USA.
| | - Stefan Cano
- Modus Outcomes, Letchworth Garden City, United Kingdom.
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14
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Klassen AF, Rae C, Gallo L, Norris JH, Bogart K, Johnson D, Van Laeken N, Baltzer HL, Murray DJ, Hol MLF, O T, Wong Riff KWY, Cano SJ, Pusic AL. Psychometric Validation of the FACE-Q Craniofacial Module for Facial Nerve Paralysis. Facial Plast Surg Aesthet Med 2021; 24:1-7. [PMID: 33826408 DOI: 10.1089/fpsam.2020.0575] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Systematic reviews have identified the need for a patient-reported outcome measure for facial nerve paralysis (FNP). The aim of this study was to determine the psychometric properties of FACE-Q Craniofacial module scales when used in a combined sample of children and older adults with FNP. Methods: Data were collected between December 2016 and December 2019. We conducted qualitative interviews with children and adults with FNP. FACE-Q data were collected from patients aged 8 years and older with FNP. Rasch measurement theory analysis was used to examine the reliability and validity of the relevant scales in the FNP sample. Results: Twenty-five patients provided 2052 qualitative codes related to appearance, physical, psychological, and social function. Many patient concerns were common across age. The field-test sample included 235 patients aged 8-81 years. Of the 13 scales examined, all 122 items had ordered thresholds and good item fit to the Rasch model. For 12 scales, person separation index values were ≥0.79 and Cronbach's alpha values were ≥0.82. The 13th scale's reliability values were ≥0.71. Conclusion: The FACE-Q Craniofacial module scales described in this study can be used to collect and compare evidence-based outcome data from children and adults with FNP.
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Affiliation(s)
- Anne F Klassen
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Charlene Rae
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Lucas Gallo
- Division of Plastic Surgery, McMaster University, Hamilton, Canada
| | - Jonathan H Norris
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, United Kingdom
| | - Kathleen Bogart
- School of Psychological Science, Oregon State University, Corvallis, Oregon, USA
| | - David Johnson
- Oxford Craniofacial Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Nancy Van Laeken
- Division of Plastic Surgery, University of British Columbia, Vancouver, Canada
| | - Heather L Baltzer
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Toronto, University Health Network, Toronto, Canada
| | - Dylan J Murray
- National Paediatric Craniofacial Centre, Children's Health Ireland, Dublin, Ireland.,Department of Plastic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Marinka L F Hol
- Department of Otolaryngocoloy and Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Teresa O
- Department of Otolaryngology-Head and Neck Surgery, Vascular Birthmark Institute of New York, Lenox Hill/Manhattan Eye, Ear and Throat Hospitals, New York, New York, USA
| | - Karen W Y Wong Riff
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Hospital for Sick Children, Ontario, Canada
| | - Stefan J Cano
- Modus Outcomes, Letchworth Garden City, United Kingdom
| | - Andrea L Pusic
- Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
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15
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Assessment of eye closure and blink with facial palsy: A systematic literature review. J Plast Reconstr Aesthet Surg 2021; 74:1436-1445. [PMID: 33952434 DOI: 10.1016/j.bjps.2021.03.059] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 10/22/2020] [Accepted: 03/11/2021] [Indexed: 02/05/2023]
Abstract
Facial palsy can cause the impairment of eye closure and affect blink, ocular health, communication, and esthetics. Dynamic surgical procedures can restore eye closure in patients with decreased facial nerve function. There are no standardized measures of voluntary and spontaneous eye closure that are used to evaluate the outcomes of blink restoration procedures. The purpose of this systematic literature review was to identify the measures used to assess normal and abnormal eye closure and blinking in patients with facial palsy. A literature search of the PubMed database using the keyword "facial nerve/surgery" was conducted. Only English language articles that pertain to the use of facial paralysis assessment systems published in the past 20 years, which involve eyelid closure were included. There were 57 articles that used a facial paralysis classification system with an eyelid closure component: House-Brackmann Facial Nerve Grading Scale (n = 43, 67%); Sunnybrook Facial Grading Scale (n = 9); palpebral fissure heights (n = 4), and the electronic clinician-graded facial function tool (n = 3) and three additional measures were reported once. Although the Terzis and Bruno Scoring System, blink ratio, and electronic, clinician-graded facial function scale(eFACE) Clinician-Graded Scoring System were valid measures of eyelid closure, there was no one comprehensive eye assessment that demonstrated all aspects of eye closure in facial palsy, which include closure amplitude, spontaneity, and quality of life. For blink assessment, eFACE is the most comprehensive tool currently available and recommended to be used with a patient-reported quality of life supplement that captures the specific domains related to facial nerve dysfunction.
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16
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Chartrand B, Al-Tamami N, Carriere JS, Moumdjian R, Saliba I, Saliba J. Outcome Measures and Quality of Life in Vestibular Schwannomas. CURRENT OTORHINOLARYNGOLOGY REPORTS 2021. [DOI: 10.1007/s40136-021-00342-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hamlet C, Williamson H, Hotton M, Rumsey N. 'Your face freezes and so does your life': A qualitative exploration of adults' psychosocial experiences of living with acquired facial palsy. Br J Health Psychol 2021; 26:977-994. [PMID: 33611831 DOI: 10.1111/bjhp.12515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 01/22/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Facial palsy (FP) is a highly visible appearance-affecting condition and can have a significant impact on facial function. Qualitative research focussing on adults' experiences of living with acquired FP is limited. This study aimed to explore the psychosocial impact of acquired FP and to gain a greater understanding of patients' experiences of treatment and care in the United Kingdom. DESIGN A qualitative interview study with individuals living with acquired FP. METHODS Ten adults with acquired FP were recruited. Their experiences were explored using semi-structured telephone interviews. Data were analysed using thematic analysis. RESULTS Five master themes were identified through the thematic analysis: 1) grappling with a new identity, 2) the psychosocial impact of living with facial palsy, 3) isolation: dealing with 'one hell of a problem on your own', 4) a life on hold, 5) coping strategies. Findings indicated high levels of distress and significant challenges in managing the functional and psychosocial changes associated with acquiring FP. Participants expressed grief for their former appearance and identity, with photographs and mirrors acting as agonizing reminders. Many reported a sense of abandonment due to uncoordinated care and, as a result, engaged in an endless and often fruitless pursuit to gain control over FP by experimenting with their own treatment. Many reported the negative impact of their altered facial expressions on social interactions and a fear of being negatively evaluated. CONCLUSIONS This study highlights a pressing need to review how FP is managed in the UK. To improve patient well-being, health care professionals could benefit from FP education, and patients from timely access to psychological support and clearer standards of care following diagnosis.
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Affiliation(s)
- Claire Hamlet
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Heidi Williamson
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Matthew Hotton
- Oxford Facial Palsy Service, Oxford University Hospitals NHS Foundation Trust, UK
| | - Nichola Rumsey
- Centre for Appearance Research, University of the West of England, Bristol, UK
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18
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Cuenca-Martínez F, Zapardiel-Sánchez E, Carrasco-González E, La Touche R, Suso-Martí L. Assessing anxiety, depression and quality of life in patients with peripheral facial palsy: a systematic review. PeerJ 2020; 8:e10449. [PMID: 33344085 PMCID: PMC7718791 DOI: 10.7717/peerj.10449] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/09/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Peripheral facial palsy (PFP) is predominantly a unilateral disorder of the facial nerve, which can lead to psychological disorders that can result in decreased quality of life. The aim of this systematic review was to assess anxiety, depression and quality of life symptoms associated with PFP. DATA SOURCES We searched the Medline, PEDro, CINAHL and Google Scholar databases to conduct this systematic review while following Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. The search was performed by two independent reviewers, and differences between the two reviewers were resolved by consensus. STUDY SELECTION The search terms used were derived from the combination of the following MeSH terms: "facial paralysis", "bell palsy", "anxiety", "anxiety disorders", "depression", "depressive disorders", "quality of life" and not MeSH: "facial palsy", "hemifacial paralysis", "facial paresis", "Peripheral Facial Paralysis", using the combination of different Boolean operators (AND/OR). DATA EXTRACTION On November 1st (2019). DATA SYNTHESIS In total, 18 cross-sectional articles and two case-control studies were selected. CONCLUSIONS The cross-sectional articles showed low methodological quality, while the case-control studies showed acceptable methodological quality. Limited evidence suggests that patients with PFP might have increased levels of anxiety and depressive symptoms. A qualitative analysis also showed limited evidence that quality of life might be diminished in patients with PFP. PROSPERO CRD42020159843.
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Affiliation(s)
- Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Eva Zapardiel-Sánchez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Enrique Carrasco-González
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Departament of Physiotherapy, Universidad CEU Cardenal Herrera, CEU Universities, Valencia, Spain
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Hotton M, Huggons E, Hamlet C, Shore D, Johnson D, Norris JH, Kilcoyne S, Dalton L. The psychosocial impact of facial palsy: A systematic review. Br J Health Psychol 2020; 25:695-727. [PMID: 32538540 DOI: 10.1111/bjhp.12440] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/11/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE Facial palsy is a condition which can lead to significant changes in facial function and appearance. People with facial palsy often report psychosocial difficulties, including withdrawal from social activities, anxiety, negative body image, and low mood. This paper aimed to review all published research investigating the psychosocial impact of facial palsy on adults. METHODS A systematic search of MEDLINE, CINAHL, EMBASE, PsycINFO, and AMED databases was performed. The quality of included studies was assessed, and data were extracted with regard to characteristics of participants; study methodology and design; outcome measures used; and psychosocial outcomes. RESULTS Twenty-seven studies met inclusion criteria. A high proportion of people with facial palsy reported clinically significant levels of anxiety and depression, with greater difficulties typically reported by females, compared to males. Other difficulties consistently reported include low quality of life, poor social function, and high levels of appearance-related distress. Objective severity of facial palsy was consistently shown to not be associated with anxiety or depression, with psychological factors instead likely mediating the relationship between the severity of facial palsy and psychosocial well-being. CONCLUSIONS Irrespective of objective symptom severity, facial palsy has the potential to have a significant impact on psychosocial well-being and quality of life. The various methodological limitations of the included studies are discussed, along with clinical implications, including the need for greater access to psychological screening and interventions for people with facial palsy.
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Affiliation(s)
- Matthew Hotton
- Oxford Facial Palsy Service, Oxford University Hospitals NHS Foundation Trust, UK
| | - Esme Huggons
- Oxford Facial Palsy Service, Oxford University Hospitals NHS Foundation Trust, UK
| | - Claire Hamlet
- Centre for Appearance Research, University of the West of England, UK
| | - Danielle Shore
- Department of Experimental Psychology, University of Oxford, UK
| | - David Johnson
- Oxford Facial Palsy Service, Oxford University Hospitals NHS Foundation Trust, UK
| | - Jonathan H Norris
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, UK
| | - Sarah Kilcoyne
- Oxford Facial Palsy Service, Oxford University Hospitals NHS Foundation Trust, UK
| | - Louise Dalton
- Oxford Facial Palsy Service, Oxford University Hospitals NHS Foundation Trust, UK
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A severe case of Ramsay Hunt Syndrome treated with acupuncture and related techniques. Complement Ther Clin Pract 2020; 39:101119. [PMID: 32379658 DOI: 10.1016/j.ctcp.2020.101119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 11/21/2022]
Abstract
Ramsay-Hunt syndrome presents with a vesicular eruption in the ear canal or oral cavity associated with ipsilateral peripheral facial paralysis. The cause is reactivation of the herpes zoster virus in the geniculate ganglion. It is the second most frequent cause of non-traumatic peripheral facial paralysis. Acupuncture is a medical procedure endorsed by the WHO with a wide range of indications. It consists of the application of very fine needles in certain points of the body to relieve pain and relieve certain diseases. We present a case of a young woman with unilateral facial paralysis as part of Ramsay Hunt syndrome. She received conventional treatment with acyclovir, analgesics, corticosteroids and eye protection measures 48 h after the onset of symptoms. At three weeks, due to the lack of improvement of the facial paralysis, manual acupuncture was started along with electroacupuncture, plum blossom hammer for facial stimulation and Chinese herbal medicine. An almost complete improvement was obtained at 14 weeks since the onset of the condition. Acupuncture and related techniques may be an effective intervention for this type of condition, and are associated with very few adverse effects.
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