A national survey of facial paralysis on the quality of life of patients with acoustic neuroma

Abstract

Objective: The aim of this survey was to objectively quantify the impact of facial palsy on the quality of life of acoustic neuroma patients.

Methods: The Facial Clinimetric Evaluation (FaCE) Scale was emailed to all members of the British Acoustic Neuroma Association (BANA).

Results: Of the 880 BANA members contacted, 398 (45.2%) responded, of which, 178 indicated that they had facial paralysis. Surgery for acoustic neuroma accounted for 80% of facial paralysis. Treatment received for facial palsy varied considerably, although 33% reported not receiving any treatment. The commonest single treatment modality wads facial electrical stimulation (41%), followed by facial physiotherapy (39%). The most common surgical procedures were to the eye lid (50%), followed by nerve graft (12%), forehead lift (10%), muscle sling (9%), and face lift (9%). The overall mean total FaCE Scale score was 54.8 (range, 10-100, standard deviation [SD] 21.2). Both facial movement and eye comfort domains had the lowest mean scores of 41.3 (SD, 29.9) and 41.2 (SD 32.6) respectively. The mean total FaCE Scale score of female respondents was statistically lower (p = 0.03) than males (52.6 (SD 21.2) versus 58.8 (SD 20.7) respectively), as were the difference in mean domain scores for facial comfort, eye comfort and social function. The mean total FaCE Scale scores of respondents aged below 40 years were the lowest. Younger patients had the lowest social function domain scores of all age groups.

Conclusion: Facial paralysis is a significant problem in patients with acoustic neuroma. Based on this survey, treatment for facial paralysis is often not offered and even when given, still leaves the patient with a significantly lowered quality of life. However, it should be remembered that this study has surveyed a skewed patient population and that overall, most acoustic neuroma patients do not suffer with facial paralysis.