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Function and quality of life after facial nerve reconstruction
A permanent facial paralysis leads to functional and psychosocial problems. The gold standard procedure for facial nerve reanimation is the facial nerve reconstruction by neuroplasty. It was the aim to evaluate quality of life, function and reinnervation after facial nerve reconstruction.
The study is based on a single-center retrospective cohort study of 51 patients who received a nerve reconstruction between 2006-2018. Besides direct nerve suture and reconstruction with interposition graft the hypoglossal-facial jump nerve suture (HFJA) and its modifications were mainly used. Quality of life was investigated by using facial clinimetric evaluation (FaCE). Facial function was assessed by Sunnybrook Facial Grading Scale (SFGS) and eFACE by using postoperative standardized photo documentation. Postoperative reinnervation was measured by using EMG.
43 patients showed a satisfying facial function after reconstruction. A significant improvement of quality of life was shown by reinnervation of M. frontalis (FaCE social function without (mean = 53,6±28,2 N = 7) with (mean = 77,3±22,7 N = 25) reinnervation; p = 0,041) and M. orbicularis oris (FaCE Total score without (mean = 40,2±15,5 N = 7) with (mean = 58,3±17,1 N = 27) reinnervation; p = 0,023). Younger age (FaCE comfort score r=-0,346; p = 0,033; N = 38) and male sex (FaCE eye comfort score, female (mean = 34,03±32,31 N = 18), male (mean = 53,13±28,06 N = 20) p = 0,048) influenced quality of life. SFGS correlated to quality of life (r = 0,422 N = 35 p = 0,012). There was no good correlation between eFACE and quality of life.
Facial nerve reconstruction is effective for improving quality of life in patients with long-term facial paralysis.
10 June 2020 (online)
© Georg Thieme Verlag KG
Stuttgart · New York