Associations Between Clinician-Graded Facial Function and Patient-Reported Quality of Life in Adults With Peripheral Facial Palsy

Abstract

IMPORTANCEUnderstanding how the quality of life of adults (Ն18 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 MEASURESThe main outcome was the association between facial function and quality of life, quantified by Pearson r, Spearman ρ, or regression analysis. RESULTSIn 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.

A cross‐sectional analysis of facial palsy‐related quality of life in 125 patients: Comparing linear, quadratic and cubic regression analyses

“…This is in line with previous research showing a weak and often non-significant correlation between facial function and the social aspect of QoL in facial palsy. 7 In a previous study, examining factors influencing quality of life in facial palsy, an explained variance of 3.8% was found for a multivariate model predicting FaCE total scores by age, gender, duration of palsy and aetiology. 8 In a follow-up study, the authors found an explained variance of 18.9% in a linear model predicting FaCE total scores by eFACE facial function scores.…”

Facial nerve palsy: Narrative review on the importance of the eye and its assessment

“…Whilst a moderate correlation was demonstrated between FaCE and Sunnybrook scores (Rho = 0.450, p = 0.014), the correlation between FaCE and eFACE was weaker and not statistically significant (Rho = 0.373, p = 0.056). Finally, in a recent meta‐analysis of 3746 patients analyzing associations between clinician and patient rated measures in adults with FNP, the pooled correlation coefficients between facial function and social function on FaCE were 0.324 (95% CI, 0.128–0.495) to 0.397 (95% CI, 0.242–0.532) 61 . The authors concluded that only a small part of QoL was explained by facial function with use of standard scales.…”

“…Finally, in a recent metaanalysis of 3746 patients analyzing associations between clinician and patient rated measures in adults with FNP, the pooled correlation coefficients between facial function and social function on FaCE were 0.324 (95% CI, 0.128-0.495) to 0.397 (95% CI, 0.242-0.532). 61 The authors concluded that only a small part of QoL was explained by facial function with use of standard scales. It is thus difficult to accurately determine the relative importance of difference regions of the face in estimating QoL using the standing grading instruments.…”

Risk of peripheral facial palsy following parenteral inactivated influenza vaccination in the elderly Chinese population

“…First, we only considered outpatient PFP cases, because NRHIP did not provide information on no-visits and inpatient cases. Due to the impact on appearance and life ( 28 , 29 ), even mild cases usually need to seek medical advice in time. However, hospitalization is generally not required.…”