A comparison of facial nerve disability between patients with Bell's palsy and vestibular schwannoma.
We compared self-assessed morbidity of facial nerve dysfunction arising from surgical intervention with those in non-surgical clinical scenarios in a cross-sectional observational study. The validated patient-graded Facial Clinimetric Evaluation (FaCE) scale and a supplementary questionnaire were mailed to adult subjects with a history of facial nerve dysfunction. Seventy-five completed survey packets were returned: 53 (71%) cases of facial nerve dysfunction were caused by surgery for vestibular schwannoma and 22 (29%) were the result of Bell's palsy. The vestibular schwannoma cohort reported less paralysis-related morbidity in the subscale domains of facial movement and social function (p < 0.03, one-way analysis of variance [ANOVA]). Within the surgical cohort, those patients expecting "likely" postoperative facial dysfunction experienced less morbidity in oral function and social function compared to those expecting "unlikely" postoperative facial dysfunction or those who did not recall having a preoperative discussion at all (p < 0.05, one-way ANOVA). Patient age, gender, history of rehabilitative measures, and duration of paralysis did not correlate with morbidity. We concluded that patients with facial nerve dysfunction arising from surgical intervention experienced less morbidity than those caused by non-surgical etiologies. Patient participation in the informed consent process and health provider setting of expectations were important factors to reduce perceived morbidity.
Saito
David M
DM
Department of Otolaryngology, Head & Neck Surgery, University of California San Francisco, San Francisco, CA, USA. saitod@pamf.org
Cheung
Steven W
SW
D000328:Adult; D000368:Aged; D020330:Bell Palsy / Q000503:physiopathology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005154:Facial Nerve / Q000503:physiopathology / Q000601:surgery; D005158:Facial Paralysis / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000503:physiopathology*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology*