Facial Paralysis: Impact of Treatment on Perceived Function and QOL

Objectives: Facial paralysis in the United States affects ~ 100,000 new patients per year with an estimated annual cost of two billion dollars. The impact is devastating, many patients experience negative social and psychological consequences, decreased social activities, and increased anxiety or depression. In this study, patients’ perceptions of the effect of paralysis, and importantly, their treatment-related recovery on quality of life (QOL) were assessed using three scales: the SF36 (general QOL), the Facial Clinimetric Evaluation (FaCE) and Recovery Perception (PSP) (condition-specific QOL).
Methods: The sample consisted of adults: 68 controls and 36 patients diagnosed with unilateral facial paralysis. The patients completed the scales at baseline (onset of paralysis) and at 12-weeks (recovery point), and the controls, at baseline.
Results: Time-specific mean subject scores were calculated for subscales of the 3 scales. Unpaired Satterwaite t- and Wilcoxon 2-sample tests were used to determine significant (p≤0.05) differences in mean subscales between the groups at baseline and at 12-weeks, and paired t- and Wilcoxon tests for significant (p≤0.05) mean changes over time for the patients
Conclusions: Compared with controls at baseline, patients had significantly lower scores for facial movement, facial comfort, oral function, eye comfort, lacrimal control, and social function (FaCE); patients had significantly higher scores for social/self-issues, general health, and dentofacial status (PSP); and patients had significantly lower scores for physical functioning, physical health, emotional problems/well-being, energy/fatigue, social functioning, pain, and general health(SF36). The differences in mean scores indicated worse function/QOL for the patients. At 12 weeks, the majority of the patients’ mean subscales were still significantly different from the controls indicating worse function/QOL. However, these differences were smaller than at baseline indicating some, but not complete, recovery. Also, the average changes from baseline to 12 weeks for a majority of subscales indicated substantial improvement in the patients’ function/QOL.