The psychological and psychosocial effects of facial paralysis: A review

Vargo, Mark A.; Ding, Peng; Sacco, Matthew P.; Duggal, Radhika; Genther, Dane J.; Ciolek, Peter J.; Byrne, Patrick J.

doi:10.1016/j.bjps.2023.05.027

Cited by 11 publications

(2 citation statements)

References 47 publications

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“…The occurrence of facial palsy is an impactful life event compromising patients’ mental and physical quality of life ( 4–6 , 34 ). Treatment objectives should provide patients with the most holistic care possible, exhausting the full regenerative potential of the facial nerve.…”

Section: Discussionmentioning

confidence: 99%

Outpatient care for facial palsy—a survey on patient satisfaction in uni- and interdisciplinary approaches

Machetanz,

Oberle,

Wang

et al. 2024

Front. Neurol.

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ObjectiveThe various causes of facial palsy, diagnostic methods and treatment approaches frequently involve different medical specialities. Nevertheless, there exist only few specialized consultation and therapy services for patients with facial palsy (FP) in Germany. The aim of the present study was to evaluate factors affecting quality of life (QoL) and treatment satisfaction of patients presenting to an interdisciplinary facial nerve outpatient clinic.MethodsThe study analyzed patients presenting to the interdisciplinary facial palsy outpatient clinic in Tuebingen between February 2019 and December 2022. General satisfaction and QoL was estimated by numerous self-rating questionnaires: ZUF-8, SF-36, FDI, FaCE, PHQ-9. An ANOVA was performed to analyze determinants affecting the ZUF-8. Correlation analyses between cause and regeneration of FP as well as questionnaire scores were performed. Results were compared with a group of patients who were managed in an unidisciplinary setting.ResultsIn total, 66 patients with FP were enrolled. FP patients showed increased levels of depression (PHQ-9: 14.52 ± 3.8) correlating with recovery of the palsy (p = 0.008), FaCE (p < 0.001) and FDI ratings (p < 0.001). There was a high level of satisfaction with the services provided during the uni-and interdisciplinary consultation (ZUF-8: 24.59 ± 6.2), especially among the 12/66 patients who received reconstructive, surgical treatment. However, some patients requested more psychological and ophthalmological support.ConclusionHigh levels of treatment satisfaction can be achieved in both an uni-and interdisciplinary setting. However, multimodal therapy approaches should be applied, considering physical and psychological aspects. In the absence of recovery, surgical interventions must be considered as treatment options. Further studies should continue to investigate potential differences between uni-and interdisciplinary treatment.

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Section: Discussionmentioning

confidence: 99%

Outpatient care for facial palsy—a survey on patient satisfaction in uni- and interdisciplinary approaches

Machetanz,

Oberle,

Wang

et al. 2024

Front. Neurol.

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“…All this and the stigmatization lead to a significantly reduced quality of life, psychosocial withdrawal and often also to depression in the affected persons. [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Surgery for patients with facial palsy in Germany: a diagnosis-related-groups-based nationwide analysis, 2005–2019

Seeberger,

Schlattmann,

Guntinas-Lichius

2023

Eur Arch Otorhinolaryngol

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Purpose Chronic flaccid paralysis of the facial nerve leads to permanent dysfunction of eye closure, problems with drinking and eating, and lack of emotional expression. Modern facial surgery can help those affected. An analysis of the development of facial surgery in Germany over time is presented. Methods Nation-wide population-baes diagnosis-related case group (DRG) data of virtually all inpatients who underwent facial surgery for facial palsy between 2005 and 2019 were included. Binomial regression models for changes in surgery rates over time were calculated in relation to gender and treating specialty. Results Between 2005 and 2019, there were 28,622 inpatient stays for facial surgery. Most surgeries were provided by otolaryngology (39%) and ophthalmology or dentistry, oral and maxillofacial surgery (20% each). The mean treatment rate was 2.33 ± 0.53 surgeries per 100,000 person-years. The surgery rate was highest for nerve reconstruction surgery (0.46 ± 0.15) and static sling surgery (0.44 ± 0.0.16). The greatest increase was seen in men for nerve surgery (3.9-fold; relative risk [RR] = 3.68; confidence interval [CI] = 3.18–4.26) and sling surgery (5.0-fold; RR = 4.25; CI = 3.38–5.33). Conclusions While nerve and sling surgery increased significantly over time, this was less true or not true at all for surgical techniques. Surgical rates and their change over time were greater in men, without explanation from the data.

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Surgery for facial palsy in the hands of otorhinolaryngologists: a population-based study

Alberts,

Ballmaier,

Boeger

et al. 2024

Eur Arch Otorhinolaryngol

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Purpose Modern facial surgery can improve eye closure and address facial functional and emotional expression disabilities in case of severe acute facial paralysis with low probability of recovery and in cases of chronic flaccid facial paralysis. Reports on outcome typically originate from specialized tertiary care centers, whereas population-based data from routine care beyond specialized centers is sparse. Methods Therefore, patients’ characteristics, surgical techniques, postoperative complications, and patients’ satisfaction with the final outcome were analyzed for all inpatients with facial paralysis undergoing facial surgery in Thuringia, a federal state in Germany, between 2006 and 2022. 260 patients (female 41.5%; median age 65 years) were included. Results On average, the surgery rate was higher for men than for women (0.83 ± 0.39 versus 0.58 ± 0.24 per 100,000 population per year). For first surgery, static procedures were dominating (67.3%), followed by dynamic reconstruction (13.8%), and combined static and dynamic reconstructions (13.5%). The most frequent type of surgery was upper lid weight loading (38.5%), hypoglossal-facial jump nerve suture (17.3%), and facial-facial interpositional graft suture (16.9%). Bleeding/hematoma formation needing revision surgery was the most frequent complication (6.2%). Overall, 70.4% of the patients were satisfied with the final result. The satisfaction was higher if the target was to improve eye closure (65.2%) or to improve upper face function (65.3%) than to improve the lower face function (53.3%). Conclusions If facial nerve reconstruction surgery and/or upper lid weight placement was performed, the satisfaction was significantly higher. If revision surgery was needed to improve the result, the satisfaction was significantly lower.

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The psychological and psychosocial effects of facial paralysis: A review

Cited by 11 publications

References 47 publications

Outpatient care for facial palsy—a survey on patient satisfaction in uni- and interdisciplinary approaches

Outpatient care for facial palsy—a survey on patient satisfaction in uni- and interdisciplinary approaches

Surgery for patients with facial palsy in Germany: a diagnosis-related-groups-based nationwide analysis, 2005–2019

Surgery for facial palsy in the hands of otorhinolaryngologists: a population-based study

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