Sinno Hani, Thibaudeau Stephanie, Izadpanah Ali, Tahiri Youssef, Christodoulou George, Zuker Ronald, Lin Samuel J
Division of Plastic and Reconstructive Surgery, Montreal General Hospital, McGill University, Montreal, Quebec, Canada.
Ann Plast Surg. 2012 Oct;69(4):435-8. doi: 10.1097/SAP.0b013e318246e698.
Facial paralysis is a debilitating condition. Dynamic and static facial reanimation remains a challenge for plastic surgeons and requires important resources. Our objective was to quantify the health state utility assessment (ie, utility score outcomes) of living with unilateral facial paralysis.
Utility assessments using visual analog scale, time trade-off, and standard gamble were used to obtain utility outcome scores for unilateral facial paralysis from a prospective sample of the general population and medical students.
A total number of 123 individuals prospectively participated in the study. All measures (visual analog scale, time trade-off, and standard gamble) for unilateral facial paralysis [0.56±0.18, 0.78±0.21, and 0.79±0.21 respectively] were significantly different (P<0.0001) from the corresponding outcome scores for monocular blindness [0.61±0.21, 0.83±0.21, and 0.85±0.18, respectively] and binocular blindness [0.33±0.18, 0.65±0.28, and 0.65±0.29, respectively]. Linear regression analysis using age, race, income, and education as predictors of each of the utility scores for facial paralysis showed no statistical significance.
In samples of the general population and medical students, all utility score outcome measures for facial paralysis were lower than those for monocular blindness. Our sample population, if faced with unilateral facial paralysis, would theoretically undergo facial reanimation procedures with a willingness to sacrifice 8 years of life and be willing to undergo a procedure with a 21% chance of mortality to attain perfect health, respectively.
面瘫是一种使人衰弱的病症。动态和静态面部重建对整形外科医生来说仍然是一项挑战,并且需要大量资源。我们的目标是量化单侧面瘫患者的健康状态效用评估(即效用评分结果)。
使用视觉模拟量表、时间权衡法和标准博弈法进行效用评估,以从前瞻性选取的普通人群和医学生样本中获得单侧面瘫的效用结果评分。
共有123人前瞻性地参与了该研究。单侧面瘫的所有测量指标(视觉模拟量表、时间权衡法和标准博弈法)[分别为0.56±0.18、0.78±0.21和0.79±0.21]与单眼失明[分别为0.61±0.21、0.83±0.21和0.85±0.18]以及双眼失明[分别为0.33±0.18、0.65±0.28和0.65±0.29]的相应结果评分相比,均有显著差异(P<0.0001)。以年龄、种族、收入和教育程度作为面瘫各效用评分的预测因素进行线性回归分析,结果无统计学意义。
在普通人群和医学生样本中,面瘫的所有效用评分结果测量值均低于单眼失明的测量值。我们的样本人群若面临单侧面瘫,理论上愿意接受面部重建手术,分别愿意牺牲8年寿命,并且愿意接受有21%死亡几率的手术以获得完美健康状态。