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Allende JEB, Caviedes R, von Marttens Castro AH, Kuga M, Fernández E. A Case Series of Low-Level Laser Therapy Treatment in Patients with Peripheral Facial Palsy. Photodiagnosis Photodyn Ther 2024:104314. [PMID: 39181489 DOI: 10.1016/j.pdpdt.2024.104314] [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: 07/17/2024] [Revised: 08/19/2024] [Accepted: 08/21/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND Peripheral Facial Palsy (PFP) is a facial paralysis with various etiologies, including idiopathic causes (Bell's palsy), infections, trauma, and genetic factors. Traditional treatments involve antiviral medications, corticosteroids, and physiotherapy. However, new therapies, such as Low-Level Laser Therapy (LLLT), are emerging with promising results. METHODS This case series reports on two patients with PFP treated with LLLT combined with Vitamin B1, B6, and B12 supplementation. The first case involved a 52-year-old female with PFP due to a viral infection. The second case was a 33-year-old male who developed PFP following a traumatic brain injury. Both patients received LLLT sessions every two weeks, targeting 10 points along the facial nerve pathway from the facial notch across the face. The laser device used was the Theraphy EC (DMC, Sao Carlos, SP, Brazil), with each point receiving 4 Joules of energy applied perpendicular to the skin after cleaning the face with water and soap to remove lipids that could interfere. The administration of Vitamin B was done using NEUROBIONTA tablets (Vitamin B1 + Vitamin B6 + Vitamin B12; Procter & Gamble, Santiago, Chile) with one tablet taken daily for 30 days. RESULTS After six to seven sessions, both patients showed significant improvement in facial muscle function and overall facial symmetry. In the first case, improvements were noted in muscle tonicity and facial movements, with the patient reporting reduced facial disfigurement. In the second case, notable recovery in facial mobility and symmetry was observed, with the patient experiencing decreased paresthesia and restored muscle functionality. CONCLUSION These findings suggest that LLLT, combined with Vitamin B1, B6, and B12 supplementation, may effectively improve facial muscle function and symmetry in PFP patients. The non-invasive nature and ease of application make LLLT a viable option for PFP treatment. Further studies with larger sample sizes and standardized protocols are necessary to confirm these results and establish LLLT as a standard treatment for PFP.
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Affiliation(s)
| | - Rodrigo Caviedes
- Restorative Dentistry Departament, Faculty of Dentistry, University of Chile.
| | | | - Milton Kuga
- Restorative Dentistry Departament, Faculty of Dentistry, UNESP-Araraquara, Brazil.
| | - Eduardo Fernández
- Restorative Dentistry Departament, Faculty of Dentistry, University of Chile and Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Chile..
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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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Kalavacherla S, Oca M, Du E, Meller L, de Cos V, Ostrander BT, Greene JJ. Temporal Development of Depression and Anxiety in a Large Facial Palsy Cohort. ORL J Otorhinolaryngol Relat Spec 2024:1-5. [PMID: 38710166 DOI: 10.1159/000539183] [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: 01/07/2024] [Accepted: 04/22/2024] [Indexed: 05/08/2024]
Abstract
INTRODUCTION Diagnosis with facial palsy (FP) has been linked to increased psychosocial distress and communication disorders, but limited data exist on the temporal development of depression and anxiety after diagnosis. In a large cohort of FP patients, we characterize the rates of depression and anxiety at several timepoints post-FP diagnosis. METHODS A de-identified database of all FP patients who presented to a single healthcare system over 22 years was created using Epic SlicerDicer. Demographics and comorbidities were collected and depression and anxiety diagnosis rates at three timepoints (non-inclusive lower bounds) post-FP diagnosis were examined. RESULTS 3,910 FP patients were identified, with a median age of 59. 56% were female and 51% were white. At 0-6, 6-12-, and 12-36-month post-FP diagnosis, 156 (4%), 58 (1.4%), and 205 (5.2%) individuals were diagnosed with depression, and 171 (4.4%), 84 (2.1%), and 237 (6.1%) were diagnosed with anxiety. At each time point, the median time between FP and depression diagnosis (2.1, 3.4, and 11.4 months) or anxiety diagnosis (2.5, 4.0, and 11.1 months) was similar. Dual depression and anxiety diagnoses were observed in 52 (1.3%), 32 (0.8%), and 122 (3.1%) patients at each time point. Compared to the overall cohort, more patients with anxiety were female (65 vs. 56%, p < 0.001) and younger (57 vs. 59, p = 0.002), and more depressed patients were Black (7.3 vs. 3.3%, p = 0.02). CONCLUSIONS Facial palsy may lead to increased risk of depression and/or anxiety in the first year after diagnosis as demonstrated here in one of the largest FP cohorts to date. We report high rates of depression (5.5%), anxiety (6.5%), and comorbid depression and anxiety (2.1%) occurring within 1 year after FP diagnosis. Of these, the majority occurred within the first 6 months (72%, 67%, 62%, respectively). Anxiety was more common in young female patients and depression more common in Black patients, which can inform targeted mental health resources within the first 6 months post-FP diagnosis.
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Affiliation(s)
- Sandhya Kalavacherla
- School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Michael Oca
- School of Medicine, University of California San Diego, La Jolla, California, USA,
| | - Eric Du
- Department of Otolaryngology- Head and Neck Surgery, University of Missouri-Columbia, Columbia, Missouri, USA
| | - Leo Meller
- School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Víctor de Cos
- School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Benjamin T Ostrander
- Department of Otolaryngology- Head and Neck Surgery, University of California San Diego, La Jolla, California, USA
| | - Jacqueline J Greene
- Department of Otolaryngology- Head and Neck Surgery, University of California San Diego, La Jolla, California, USA
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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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Jeong J, Yoon SR, Lim H, Nam Y, Choi HS. Risk for depression and anxiety in patients with facial palsy based on population-based data from Korea. Acta Otolaryngol 2023; 143:1001-1004. [PMID: 38240110 DOI: 10.1080/00016489.2024.2302899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/01/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Several studies point out the association of facial palsy with psychiatric distress such as depression and anxiety. However, there have been few studies on this association based on population-based data. OBJECTIVES To investigate the risk for depression and anxiety disorders in patients with Bell's palsy and in those with Ramsay Hunt syndrome. MATERIALS AND METHODS This retrospective study included data from the Korean National Health Insurance Service National Sample Cohort. From 2006 to 2015, patients with Bell's palsy and those with Ramsay Hunt syndrome were defined using diagnostic and medication claim codes. Patients with depression or anxiety were defined using diagnostic and medication claim codes. Occurrences of depression and anxiety were included in analyses. RESULTS There were significantly higher risks for depressive and anxiety disorders in the group of patients with Bell's palsy than in the control group, as well as in the group of patients with Ramsay Hunt syndrome than in the control group. CONCLUSIONS AND SIGNIFICANCE There were significantly higher risks for depression and anxiety in patients with facial palsy including Bell's palsy and Ramsay Hunt syndrome based on population-based data from Korea.
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Affiliation(s)
- Junhui Jeong
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - So Ra Yoon
- Research and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Hyunsun Lim
- Research and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Yunbin Nam
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Hyun Seung Choi
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
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Ko MJ, Goo B, Kim JH, Nam SS. Clinical effect and safety of thread embedding acupuncture on facial nerve palsy sequelae: A retrospective observational study. Medicine (Baltimore) 2023; 102:e32773. [PMID: 36749259 PMCID: PMC9901958 DOI: 10.1097/md.0000000000032773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The purpose of this study was to investigate the clinical effect and safety of thread embedding acupuncture (TEA) in patients with facial nerve palsy sequelae. This was a retrospective observational study on 82 patients treated with TEA from January 2021 to May 2022. The Facial Disability Index (FDI) reported by patients and Sunnybrook Facial Grading System scores assessed by clinical practitioners were used to evaluate the intensity of facial movements, functional problems, and psychosocial status. One-way repeated measure analysis of variance showed that the Sunnybrook Facial Grading System scores improved significantly following the 2nd to 6th TEA treatments (Txs). FDI scores also showed significant increases except for the 4th Tx. Additionally, the physical scores improved significantly among the subscales of FDI, but the social/well-being scores did not. There were no reported serious adverse events or adverse events requiring medical Tx. TEA is a safe Tx that has a clinically cumulative effect, in terms of patient-oriented self-assessment of functional problems and objective facial movements, for treating facial nerve palsy sequelae.
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Affiliation(s)
- Min-Jung Ko
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Dongdaemun-gu, Seoul, Republic of Korea
| | - Bonhyuk Goo
- Department of Acupuncture & Moxibustion, Kyung Hee University Hospital, Gangdong-gu, Seoul, Republic of Korea
| | - Jung-Hyun Kim
- Department of Acupuncture & Moxibustion, Kyung Hee University Hospital, Gangdong-gu, Seoul, Republic of Korea
| | - Sang-Soo Nam
- Department of Acupuncture & Moxibustion, Kyung Hee University College of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
- * Correspondence: Sang-Soo Nam, Department of Acupuncture & Moxibustion, Kyung Hee University College of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea (e-mail: )
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Rist TM, Segars K, Oyer SL. Influence of Subclinical Anxiety and Depression on Quality of Life and Perception of Facial Paralysis. Facial Plast Surg Aesthet Med 2023; 25:27-31. [PMID: 35984930 DOI: 10.1089/fpsam.2022.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Introduction: Patients with facial paralysis have increased psychosocial distress, which affects overall quality of life (QOL). Objective: To evaluate the relationship between QOL and paralysis severity among patients with subclinical anxiety and/or depression. Methods: Patients with facial paralysis were screened for anxiety and depression using the Generalized Anxiety Disorder-2 and Patient Health Questionnaire-2 surveys. QOL scores (Facial Clinimetric Evaluation) and paralysis severity scores (House-Brackmann [HB] and Sunnybrook [SB]) were collected. Patients with a mental health diagnosis or treatment were excluded. Univariate and multivariate analyses and Pearson's correlations were performed after stratifying by anxiety and/or depression screenings. Results: Positive anxiety and depression screening rates were 25.78% and 22.66%, respectively. Patients screening positive had significantly worse QOL scores despite no difference in paralysis severity. QOL scores did not correlate with SB scores among patients who screened positive for depression. Conclusion: Patients screening positive for anxiety and/or depression demonstrated worse QOL, which did not correlate with paralysis severity suggesting that health care professionals should remain alert to mental health symptoms when QOL impairment is out of proportion with the severity of paralysis.
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Affiliation(s)
- Tyler M Rist
- Department of Otolaryngology Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Kelly Segars
- Department of Radiology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Samuel L Oyer
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology Head and Neck Surgery, University of Virginia, Charlottesville, Virginia, USA
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Ali L, Alhatou M, Adeli G, Elalamy O, Zada Y, Mohammed I, Sharif M, Noor Illahi M, Naeem M, Iqrar A. Lesion Localization and Prognosis Using Electrodiagnostic Studies in Facial Diplegia: A Rare Variant of Guillain-Barre Syndrome. Cureus 2022; 14:e25047. [PMID: 35719795 PMCID: PMC9200109 DOI: 10.7759/cureus.25047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/06/2022] Open
Abstract
Background The etiology of facial nerve palsy is diverse and includes herpes zoster virus, Guillain-Barre syndrome (GBS), otitis media, Lyme disease, sarcoidosis, human immunodeficiency virus, etc. The lower motor neuron type facial nerve palsy is usually caused by an ipsilateral facial nerve lesion; however, it may be caused by a central lesion of the facial nerve nucleus and tract in the pons. Facial diplegia is an extremely rare condition that occurs in approximately 0.3% to 2.0% of all facial palsies. Electrodiagnostic studies including direct facial nerve conduction, facial electromyography (EMG), and blink reflex studies are useful for the prognosis and lesion localization in facial nerve palsy. Methodology This retrospective, observational study was conducted at the Neurophysiology Unit, Hamad General Hospital, Doha, Qatar. This study included 11 patients with bilateral facial weakness who visited for electrodiagnostic studies in the neurophysiology laboratory. Results In total, eight (72.7%) patients had facial diplegia, eight (72.7%) had hypo/areflexia, seven (63.6%) had facial numbness, and five (45.5%) had cerebrospinal fluid albuminocytological dissociation. The most frequent cause of facial diplegia in this study was GBS (81.9%). Direct facial nerve conduction stimulation showed that nine (81.8%) patients had bilateral facial nerve low compound muscle action potential amplitudes. The bilateral blink reflex study showed that eight (88.8%) patients had absent bilateral evoked responses. Finally, the EMG study showed that five (55.5%) patients had active denervation in bilateral sample facial muscles. Conclusions Bilateral facial nerve palsy is an extremely rare condition with a varied etiology. Electrodiagnostic studies are useful in detecting the underlying pathophysiologic processes, prognosis, and central or peripheral lesion localization in patients with facial diplegia.
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Savytska IB. Clinical case of peripheral facial palsy as first and single COVID-19 symptom in an immunized patient. 18 2021. [DOI: 10.26565/2312-5675-2021-18-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
SARS-CoV-2 virus affects the central as well as the peripheral nervous system. Peripheral facial palsy is possible as the first and single COVID-19 symptom. The author presents own clinical observation of a 58-year-old patient with peripheral facial palsy. It is known that the patient completed the vaccination 8 weeks ago and also had direct contact with the patient SARS-CoV-2 (the patient's son). Facial nerve palsy was the first and only symptom of coronavirus infection. In the blood there was a moderate lymphocytopenia, increased interleukin-6, C-reactive protein, seromukoids. MRI of the brain and CT of the temporal bones did not reveal focal and diffuse pathology. After treatment, there was a complete recovery on the ninth day of treatment. Treatment included antiviral drugs, vitamins, steroids, kinesiotaping of facial muscles. The author substantiates necessity and demonstrates the results of treatment with endothelioprotective therapy (combination of L-arginine and L-carnitine) , which is aimed at elimination of systemic inflammation, oxidative stress caused by SARS-CoV-2 virus.
Conclusions. General practitioner need to be alert when examining patients, including those who have been vaccinated and those who have direct contact with patients with coronavirus infection. Pathogenesis of peripheral facial palsy in COVID-19 multidirectional: neuroinvasive and neurotropic effect of the virus on the nerve, hypercoagulation, ischemia of the peripheral nerve on the background of systemic inflammatory reaction, oxidative stress. Timely detection, careful monitoring and adequate treatment of pathology are necessary to prevent complications (persistent facial contractures, synkinesis). Further in-depth studies are needed on a larger sample of patients to identify the incidence of peripheral facial nerve palsy in COVID-19 and the possibility of a link to vaccination.
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Ho J, Markowsky A. Diagnosis and Management of Bell’s Palsy in Primary Care. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Zhang Z, Zheng X, Zhang D, Zhang J, Li F, Li C, Wang X, Li J, Han D, Zhang J. Vestibular Schwannomas in Young Patients: A 12-Year Experience in a Single Center. World Neurosurg 2021; 158:e166-e178. [PMID: 34710579 DOI: 10.1016/j.wneu.2021.10.145] [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: 09/13/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study evaluated the characteristics of vestibular schwannomas (VS) in young patients, including clinical features, treatment, prognosis, and histopathologic characteristics. METHODS We retrospectively reviewed medical records and follow-up data for 36 pediatric patients <21 years of age who were surgically treated for VS in the Chinese PLA General Hospital between 2008 and 2019. RESULTS Mean patient age was 17.4 years. Mean tumor size was 2.8 cm. Hearing loss (n = 32, 88.9%) and tinnitus (n = 20, 55.6%) were the most common symptoms. Ten patients (27.8%) had impaired facial nerve function after surgery. Gross total resection (GTR) was achieved in 26 cases (72.2%). The median tumor Ki-67 level was 5%. Tumor size was related to incomplete tumor resection (odds ratio, 0.2; 95% confidence interval, 0.1-0.9) and postoperative facial nerve dysfunction (odds ratio, 24.9; 95% confidence interval, 1.2-539.1). Tumor size was nonlinearly associated with prognosis and 2.2 cm corresponded to the inflection point at which the probability of tumor remnant and postoperative facial nerve dysfunction significantly increased. The GTR and low Ki-67 groups achieved better 3-year tumor control rate. Histopathologic findings confirmed the presence of cellular schwannoma subtype in young patients. CONCLUSIONS Tumor size is an important factor affecting the prognosis of VS in young patients. For large VS, surgical treatment should be the first choice, rather than wait-and-scan. VS in young patients shows high tumor proliferation and a tendency to relapse. The cellular schwannoma subtype requires special attention; an accurate histopathologic diagnosis is necessary for young patients with VS, and a closer follow-up strategy should be adopted for cellular VS.
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Affiliation(s)
- Zehan Zhang
- Medical School of Chinese PLA, Beijing, China; Department of Neurosurgery, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Xuan Zheng
- Department of Neurosurgery, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Ding Zhang
- Medical School of Chinese PLA, Beijing, China; Department of Neurosurgery, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Jiashu Zhang
- Department of Neurosurgery, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Fangye Li
- Department of Neurosurgery, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Chong Li
- Department of Neurosurgery, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Xiuying Wang
- Department of Neurosurgery, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Jie Li
- Department of Pathology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Dongyi Han
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
| | - Jun Zhang
- Department of Neurosurgery, the First Medical Centre, Chinese PLA General Hospital, Beijing, China.
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Goo B, Kim HN, Kim JH, Nam SS. A bibliometric analysis of research on the treatment of facial nerve palsy. Medicine (Baltimore) 2021; 100:e26984. [PMID: 34414977 PMCID: PMC8376370 DOI: 10.1097/md.0000000000026984] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 07/19/2021] [Accepted: 07/27/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND There are various treatments for facial nerve palsy, and research into this topic is ongoing. In the present study, we carried out bibliometric and visualized analyses to identify the trends of research into facial nerve palsy treatment. METHODS To identify articles, the SCOPUS database was searched for articles published from its inception to December 27, 2020. The search was conducted twice, with Search 1 investigating general treatment trends and Search 2 narrowing the scope to complementary and alternative treatment. The extracted keywords were analyzed using the Visualization Of Similarities (VOS) viewer. Through analysis of keywords, research hotspots in the treatment of facial nerve palsy were identified. RESULTS A total of 1609 and 223 articles were identified in Searches 1 and 2, respectively. The number of articles published each year showed a tendency to increase, and most of the studies were only conducted in a few countries. In terms of subject area, "medicine" was overwhelmingly the most common(77.6%). Based on the analysis of 316 keywords in Search1, "medication treatment," and "complementary and alternative treatment" were the hotspots of research. CONCLUSION This study provides the overall trends of facial nerve palsy treatment. To date, research on medication treatment has been main focus, and antiviral use among medication treatment and complementary and alternative treatment has emerged in recent years.
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Affiliation(s)
- Bonhyuk Goo
- Department of Acupuncture & Moxibustion, Kyung Hee University Hospital at Gangdong, Gangdong-gu
| | - Ha-Na Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Dongdaemun-gu
| | - Jung-Hyun Kim
- Department of Acupuncture & Moxibustion, Kyung Hee University Hospital at Gangdong, Gangdong-gu
| | - Sang-Soo Nam
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, Republic of Korea
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Bruins TE, van Veen MM, Werker PMN, Dijkstra PU, Broekstra DC. Associations Between Clinician-Graded Facial Function and Patient-Reported Quality of Life in Adults With Peripheral Facial Palsy: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg 2021; 147:717-728. [PMID: 34196663 DOI: 10.1001/jamaoto.2021.1290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Understanding how the quality of life of adults (≥18 years) with peripheral facial palsy can be estimated using clinician measures of facial function and patient-reported variables might aid in counseling patients and in conducting research. Objectives To analyze associations between clinician-graded facial function and patient-reported quality of life in adults with peripheral facial palsy, compare associations between facial function and the physical and social functions of quality of life, and examine factors that might influence the associations. Data Sources A literature search was conducted in PubMed, Embase, CINAHL, Web of Science and PsycInfo on June 4, 2020, with no restrictions on the start date. Study Selection Twenty-three studies reporting an association between clinician-graded facial function and patient-reported quality of life in adults with peripheral facial palsy were included. Facial function instruments included the House-Brackmann, Sunnybrook Facial Grading System, and electronic clinician-graded facial function assessment. Quality-of-life instruments included the Facial Disability Index and Facial Clinimetric Evaluation Scale. Data Extraction and Synthesis Data extraction and qualitative synthesis were performed according to the Meta-analysis of Observational Studies in Epidemiology guidelines. Record screening, data extraction, and quality assessments were done by 2 researchers independently. Data were pooled using random-effects models. Main Outcomes and Measures The main outcome was the association between facial function and quality of life, quantified by Pearson r, Spearman ρ, or regression analysis. Results In total, 23 studies (3746 participants) were included. In the 21 studies that reported on the sex of the cohorts, there were 2073 women (57.3%). Mean or median age ranged from 21 to 64 years and mean or median duration of palsy ranged from newly diagnosed to 12 years. Bell palsy (n = 1397), benign tumor (n = 980), and infection (n = 257) were the most common etiologic factors. Pooled correlation coefficients were 0.424 (95% CI, 0.375-0.471) to 0.533 (95% CI, 0.447-0.610) between facial function and Facial Clinimetric Evaluation Scale total, 0.324 (95% CI, 0.128-0.495) to 0.397 (95% CI, 0.242-0.532) between facial function and Facial Clinimetric Evaluation Scale social function, 0.423 (95% CI, 0.322-0.514) to 0.605 (95% CI, -0.124-0.910) between facial function and Facial Disability Index physical function, and 0.166 (95% CI, 0.044-0.283) to 0.208 (95% CI, 0.031-0.373) between facial function and Facial Disability Index social function. Conclusions and Relevance Associations noted in this systematic review and meta-analysis were overall low to moderate, suggesting that only a small part of quality of life is explained by facial function. Associations were higher between facial function and physical function than social function of quality of life.
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Affiliation(s)
- Tessa E Bruins
- University of Groningen, Department of Plastic Surgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Martinus M van Veen
- University of Groningen, Department of Plastic Surgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Paul M N Werker
- University of Groningen, Department of Plastic Surgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Pieter U Dijkstra
- University of Groningen, Center for Rehabilitation, Groningen, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Dieuwke C Broekstra
- University of Groningen, Department of Plastic Surgery, University Medical Center Groningen, Groningen, the Netherlands
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