Nonmotor disabilities in patients with facial palsy measured by patient-reported outcome measures

Abstract

Objectives/hypothesis: To describe changes of motor and nonmotor disabilities in patient with peripheral facial palsy (FP) during treatment using the patient-reported outcome measures (PROMs) Facial Clinimetric Evaluation (FaCE), Facial Disability Index (FDI), and Short Form 36-Item Questionnaire (SF-36) and to analyze predictors for these changes

Study design: Prospective, single-center longitudinal study.

Methods: One hundred twenty patients with FP underwent at least two PROMs between 2012 and 2015. Predictors for changes of the PROMs were analyzed univariately using Pearson's correlation and multivariately using linear regression models.

Results: The mean interval between onset of FP to first presentation was 29 ± 64 months and between first and final assessment 8.7 ± 7.2 months. Initial House-Brackmann grading was 4.0 ± 1.3 and final House-Brackmann grading was 2.8 ± 1.6 (P < .001). All mean FaCE and FDI but only some SF-36 subscores improved over time (all P < .05). Adjuvant treatment was an independent predictor for improvement of the FaCE Facial Comfort subscore (P = .015) and a malignant tumor as primary disease for improvement of the FaCE Oral Function subscore (P = .044). Unemployment was a predictor for improvement of the FDI Social/Well-Being Function (P = .035). First assessment <90 days after onset was a predictor for improvement of the SF-36 Bodily Pain subscore (P = .025), a primary malignant disease for improvement of the SF-36 General Health perception (P = .004), and idiopathic FP for improvement of the SF-36 Social Functioning subscore (P = .017).

Conclusions: Changes of motor function revealed by classical grading systems mostly do not correlate with changes of nonmotor disabilities during treatment of FP. Many other factors are associated with changes of PROMs during the FP treatment.

Level of evidence: 4. Laryngoscope, 126:1516-1523, 2016.

Keywords: Bell's palsy; Facial Clinimetric Evaluation scale; Facial Disability Index; chronic palsy; facial nerve; patient-oriented methods; quality of life.