The psychosocial impact of facial palsy: Our experience in one hundred and twenty six patients

Walker, David T.; Hallam, Marc-James; Mhurchadha, S. Ni; McCabe, Patrick; Nduka, Charles

doi:10.1111/coa.12026

Cited by 68 publications

(58 citation statements)

References 10 publications

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“…4,29–31 However, few studies have characterized the impact of facial paralysis on depression. In a retrospective study, Walker et al 32 found that 40% of patients with facial paralysis showed symptoms suggestive of an anxiety or depressive mood disorder. Moreover, Pouwels et al 33 showed that 27% of patients with facial paralysis, either before or after surgery, were identified as having a depressive disorder.…”

Section: Discussionmentioning

confidence: 99%

Association Among Facial Paralysis, Depression, and Quality of Life in Facial Plastic Surgery Patients

Nellis

Ishii

Byrne

et al. 2017

JAMA Facial Plast Surg

169

127

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IMPORTANCE Though anecdotally linked, few studies have investigated the impact of facial paralysis on depression and quality of life (QOL).OBJECTIVE To measure the association between depression, QOL, and facial paralysis in patients seeking treatment at a facial plastic surgery clinic.DESIGN, SETTING, PARTICIPANTS Data were prospectively collected for patients with all-cause facial paralysis and control patients initially presenting to a facial plastic surgery clinic from 2013 to 2015. The control group included a heterogeneous patient population presenting to facial plastic surgery clinic for evaluation. Patients who had prior facial reanimation surgery or missing demographic and psychometric data were excluded from analysis.MAIN OUTCOMES AND MEASURES Demographics, facial paralysis etiology, facial paralysis severity (graded on the House-Brackmann scale), Beck depression inventory, and QOL scores in both groups were examined. Potential confounders, including self-reported attractiveness and mood, were collected and analyzed. Self-reported scores were measured using a 0 to 100 visual analog scale. RESULTSThere was a total of 263 patients (mean age, 48.8 years; 66.9% were female) were analyzed. There were 175 control patients and 88 patients with facial paralysis. Sex distributions were not significantly different between the facial paralysis and control groups. Patients with facial paralysis had significantly higher depression, lower self-reported attractiveness, lower mood, and lower QOL scores. Overall, 37 patients with facial paralysis (42.1%) screened positive for depression, with the greatest likelihood in patients with House-Brackmann grade 3 or greater (odds ratio, 10.8; 95% CI, 5.13-22.75) compared with 13 control patients (8.1%) (P < .001). In multivariate regression, facial paralysis and female sex were significantly associated with higher depression scores (constant, 2.08 [95% CI, 0.77-3.39]; facial paralysis effect, 5. 98 [95% CI,]; female effect, 1.95 [95% CI, 0.65-3.25]). Facial paralysis was associated with lower QOL scores (constant, 81.62 [95% CI,]; facial paralysis effect, −16.06 [95% CI,).CONCLUSIONS AND RELEVANCE For treatment-seeking patients, facial paralysis was significantly associated with increased depression and worse QOL scores. In addition, female sex was significantly associated with increased depression scores. Moreover, patients with a greater severity of facial paralysis were more likely to screen positive for depression. Clinicians initially evaluating patients should consider the psychological impact of facial paralysis to optimize care.LEVEL OF EVIDENCE 2.

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Section: Discussionmentioning

confidence: 99%

Association Among Facial Paralysis, Depression, and Quality of Life in Facial Plastic Surgery Patients

Nellis

Ishii

Byrne

et al. 2017

JAMA Facial Plast Surg

169

127

View full text Add to dashboard Cite

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“…The inability to communicate thoughts and interact with others is debilitating and results in substantial psychosocial morbidity in this patient population. 2,3 …”

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confidence: 99%

Photographic Standards for Patients With Facial Palsy and Recommendations by Members of the Sir Charles Bell Society

Santosa

Fattah

Gavilán

et al. 2017

JAMA Facial Plast Surg

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IMPORTANCEThere is no widely accepted assessment tool or common language used by clinicians caring for patients with facial palsy, making exchange of information challenging. Standardized photography may represent such a language and is imperative for precise exchange of information and comparison of outcomes in this special patient population.OBJECTIVES To review the literature to evaluate the use of facial photography in the management of patients with facial palsy and to examine the use of photography in documenting facial nerve function among members of the Sir Charles Bell Society-a group of medical professionals dedicated to care of patients with facial palsy. DESIGN, SETTING, AND PARTICIPANTSA literature search was performed to review photographic standards in patients with facial palsy. In addition, a cross-sectional survey of members of the Sir Charles Bell Society was conducted to examine use of medical photography in documenting facial nerve function. The literature search and analysis was performed in August and September 2015, and the survey was conducted in August and September 2013. MAIN OUTCOMES AND MEASURESThe literature review searched EMBASE, CINAHL, and MEDLINE databases from inception of each database through September 2015. Additional studies were identified by scanning references from relevant studies. Only English-language articles were eligible for inclusion. Articles that discussed patients with facial palsy and outlined photographic guidelines for this patient population were included in the study. The survey was disseminated to the Sir Charles Bell Society members in electronic form. It consisted of 10 questions related to facial grading scales, patient-reported outcome measures, other psychological assessment tools, and photographic and videographic recordings. RESULTSIn total, 393 articles were identified in the literature search, 7 of which fit the inclusion criteria. Six of the 7 articles discussed or proposed views specific to patients with facial palsy. However, none of the articles specifically focused on photographic standards for the population with facial palsy. Eighty-three of 151 members (55%) of the Sir Charles Bell Society responded to the survey. All survey respondents used photographic documentation, but there was variability in which facial expressions were used. Eighty-two percent (68 of 83) used some form of videography. From these data, we propose a set of minimum photographic standards for patients with facial palsy, including the following 10 static views: at rest or repose, small closed-mouth smile, large smile showing teeth, elevation of eyebrows, closure of eyes gently, closure of eyes tightly, puckering of lips, showing bottom teeth, snarling or wrinkling of the nose, and nasal base view. CONCLUSIONS AND RELEVANCEThere is no consensus on photographic standardization to report outcomes for patients with facial palsy. Minimum photographic standards for facial paralysis publications are proposed. Videography of the dynamic movements of these views should also be ...

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“…1,2 There is probably no benign ailment that causes more physical and emotional suffering. 1,2 There is probably no benign ailment that causes more physical and emotional suffering.…”

Section: Introductionmentioning

confidence: 99%

Antiviral agents convey added benefit over steroids alone in Bell's palsy; decompression should be considered in patients who are not recovering

Brennan

Martens

2015

J. Laryngol. Otol.

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The psychosocial impact of facial palsy: Our experience in one hundred and twenty six patients

Cited by 68 publications

References 10 publications

Association Among Facial Paralysis, Depression, and Quality of Life in Facial Plastic Surgery Patients

Association Among Facial Paralysis, Depression, and Quality of Life in Facial Plastic Surgery Patients

Photographic Standards for Patients With Facial Palsy and Recommendations by Members of the Sir Charles Bell Society

Antiviral agents convey added benefit over steroids alone in Bell's palsy; decompression should be considered in patients who are not recovering

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