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Measuring outcomes in facial palsy treatment: adding extra dimensions to a complex matter

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Abstract

The human face is crucial in social interaction and demonstrates cues of health, trustworthiness, emotions, and much more. A peripheral facial palsy (PFP) refers to a lower motor neuron lesion of the facial nerve and, due to its anatomy, could have many etiologies, such as traumatic, idiopathic, infectious, and oncological. Approximately 30% are left with long-term sequelae and 4% with severe dysfunction. For facial plastic surgeons, a PFP represents a great reconstructive challenge. It is a debilitating condition with functional (corneal exposure, epiphora, oral incompetence, and nasal obstruction, among others) and aesthetic sequelae that often result in physical, psychosocial, communicative, and quality-of-life losses. It remains the question how we measure the effects of the treatment of patients with a facial palsy, since there are many variety in cosmetic appreciation, surgical goals, patients’ needs, and measuring tools. The aims of this narrative review are: 1) to give an overview of conservative measuring and classification tools, 2) clinician-graded instruments versus patient-graded instruments, and 3) which domains should be considered when assessing effects of our treatment.

Level of evidence: Not gradable.

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  1. Sjaak Pouwels and Salvatore Sanfilippo contributed equally to the manuscript.

Authors and Affiliations

  1. Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands

    Sjaak Pouwels

  2. Department of Surgery, RKH Kliniken Bietigheim-Vaihingen, Bietigheim-Bissingen, Germany

    Salvatore Sanfilippo

  3. Department of Otorhinolaryngology, Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands

    Sjaak Pouwels, Koen J. A. O. Ingels & Frank W. De Jongh

  4. Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK

    Eloise Owen

  5. Department of Plastic, Reconstructive and Aesthetic Surgery, Ghent University Hospital, Ghent, Belgium

    Phillip Blondeel & Stan J. Monstrey

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Contributions

Initial idea: SP, SS.

Conception and design of the study: SP, SS, EO, KI, FdJ, PB, SM.

Drafting and revision manuscript: SP, SS, EO, KI, FdJ, PB, SM.

Final approval: SP, SS, EO, KI, FdJ, PB, SM.

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Correspondence to Sjaak Pouwels.

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Sjaak Pouwels, Salvatore Sanfilippo, Eloise Owen, Koen J. A. O. Ingels, Frank W. De Jongh, Phillip Blondeel and Stan J. Monstrey declare no conflict of interest.

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Pouwels, S., Sanfilippo, S., Owen, E. et al. Measuring outcomes in facial palsy treatment: adding extra dimensions to a complex matter. Eur J Plast Surg 45, 533–542 (2022). https://doi.org/10.1007/s00238-021-01937-8

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