title: Expression of emotion and quality of life after facial nerve paralysis.
abstract: OBJECTIVE
  To investigate the facial expression of emotion and quality of life in patients after long-term facial nerve paralysis.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Facial nerve paralysis clinic.
  
  
  METHODS
  Twenty-four patients with facial nerve paralysis and 24 significant others (partner, relative, friend).
  
  
  METHODS
  Patients were assessed using Sunnybrook, Sydney, and House-Brackmann grading scales and SF-36, Glasgow Benefit Inventory, and Facial Disability Index quality-of-life measures.
  
  
  RESULTS
  When patients identified themselves as either effective or not effective at facially communicating each of Ekman's primary emotions (happiness, disgust, surprise, anger, sadness, and fear), 50% classified themselves as not effective at expressing one or more of the six emotions. Significant others of the not effective patients rated the emotions as more difficult for their partner-patients to communicate facially than did the significant others of effective patients. The SF-36 quality-of-life survey revealed lower social functioning relative to physical functioning for not effective patients. From the Sunnybrook Facial Grading System, more synkinesis was found for those patients not effective at expressing happiness, less brow and eye movement for patients not effective at expressing sadness, and less voluntary movement for those not effective with surprise.
  
  
  CONCLUSIONS
  Movement deficits associated with expressing specific emotions and an association with quality-of-life measures were identified in patients with long-term facial nerve paralysis who saw themselves as not effective at facial expression of emotions. To improve management of emotional expression in patients with facial nerve paralysis, a broader approach is recommended, linking the practitioner's treatment goals with patient-driven outcome goals.
authors.affiliation: School of Physiotherapy, The University of Sydney, Royal Prince Alfred Hospital, Sydney, Australia. slink@zeta.org.au
authors.forename: Susan E
authors.initials: SE
authors.lastname: Coulson
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: O'dwyer
authors.forename: Roger D
authors.initials: RD
authors.lastname: Adams
authors.forename: Glen R
authors.initials: GR
authors.lastname: Croxson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004644:Emotions; D005149:Facial Expression; D020220:Facial Nerve Injuries / Q000523:psychology* / Q000601:surgery; D005158:Facial Paralysis / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D021641:Recognition, Psychology; D012649:Self Concept; D012938:Social Perception; D011795:Surveys and Questionnaires