Vilela, M. Facial mimicry performance and quality of life in the acute phase of peripheral facial paralysis [dissertacion]. Ribeirão Preto: University of São Paulo, School of Medicine of Ribeirão Preto; 2019.Introduction: Peripheral facial paralysis (PFP) is the most common cranial neuropathy, which the facial nerve responsible for facial mime loses its function.Therefore, it is understood the importance of investigating the psychological impact that it causes in the patients of this pathology and the damages regarding the muscular function to aid in the diagnosis and prognosis.
Objectives:To analyze the performance of facial mimicry in PFP compared to healthy control subjects and their relation with quality of life (QOL) and severity of motor impairment. Methods: This research was a cross-sectional observational study in which patients with unilateral acquired PFP in the acute phase, between 18 and 59 years old (GPFP) and healthy control subjects (CG) at the same age group. A total of 236 subjects with facial paralysis were screened, and of these, 35 subjects with Bell's palsy comprised the GPFP, the mean age was 34.2 years (± 13.6) and 28 subjects with GC with a mean age of 33.9 years (± 13.1). Patients with PFP were classified according to the degree of motor engagement of House and Brackmann. The Facial Disability Index -FDI (physical and social), related to QOL, the Facial Mimicry Mobility Assessment (FMMA) and the Three-Dimensional Analysis (3D) of the Facial Movement were investigated. The non-parametric Mann Whitney test was used in the comparison between the groups for the FDI, FMMA and 3D analysis.Spearman's correlation test analyzed the relationship between the PFP grade and the other variables. Results: Regarding FDI, the GPFP has significantly lower scores than the CG for both subscripts: physical (P <0,0001) and social (P <0,0141). Women with PFP appear to suffer more socially than men (P = 0,046). The overall values of facial mimicry generated by the FMMA were also lower in the GPFP compared to the CG (P <0,0001), as well as in the individual comparison of each muscle (P <0,0001). The 3D analysis showed significantly higher asymmetry indexes in GPFP (P <0,0001). There was a correlation between the degree of PFP and QOL for physical (ρ = -0,40, P <0,01); between the increase in age and worsening of QOL for physical (ρ = -0,45, P <0,005).The FMMA showed correlation with the degree (ρ = -0,65, P <0,0001) and with the QOL for physical (ρ = 0,56, P = 0,0004). Regarding the 3D analysis, all the facial mimicry tests searched correlated with the degree of the PFP, except for the lip protrusion test and the tests of surprise, open smile and closed smile were correlated with the QOL. Conclusions: Patients with PFP have a deficit in muscle function when compared to healthy control group in relation to facial capacity related to QOL, facial mimicry and facial asymmetry differences, with women suffering more in the social context in relation to QOL. The physical capacity related to QOL was influenced by PFP sev...