Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Laryngoscope. 2013 May;123(5):1256-60. doi: 10.1002/lary.23790. Epub 2013 Apr 2.
OBJECTIVES/HYPOTHESIS: The severity of Bell's facial palsy is monitored through physician-graded instruments, like the House-Brackmann or Sunnybrook Facial Grading System (FGS). These instruments primarily measure the degree of facial muscle impairment and its resulting asymmetry, but neglect the other functional aspects of facial disability. The aim of this study is therefore to compare the FGS with a patient-graded quality-of-life (QOL) instrument, Facial Clinimetric Evaluation Scale (FaCE).
Prospective longitudinal study.
Twenty-one patients with newly diagnosed Bell's palsy were recruited. All patients received standard treatment with a corticosteroid. They were scored with the FGS at every visit, and they also completed the FaCE at baseline and when they recovered from their palsy.
At presentation, there was a positive correlation between the FGS score and the total FaCE score (ρ = 0.63, P = .002). However, when individual domains of the FaCE score were analyzed separately, the domains of facial comfort and lacrimal score did not have significant correlation with the FGS. Similarly, at the end of follow-up, the amount of improvement in FGS and the amount of improvement in the FaCE domains of facial comfort, lacrimal control, and social function showed insignificant and low correlation (P < .05).
This is the first longitudinal study comparing scores on the FGS and FaCE in patients with Bell's palsy. Our findings suggest that without patient-based QOL assessments such as the FaCE, certain functional aspects of facial disability may be overlooked by physician-graded instruments, which focus on facial aesthetics.
目的/假设：贝尔面瘫的严重程度通过医生评分的仪器进行监测，如 House-Brackmann 或 Sunnybrook 面部分级系统 (FGS)。这些仪器主要测量面部肌肉损伤的程度及其导致的不对称，但忽略了面部残疾的其他功能方面。因此，本研究的目的是将 FGS 与患者评分的生活质量 (QOL) 仪器——面部临床计量评估量表 (FaCE) 进行比较。
前瞻性纵向研究。
招募了 21 名新诊断为贝尔面瘫的患者。所有患者均接受标准皮质类固醇治疗。他们在每次就诊时接受 FGS 评分，并且在基线和面瘫恢复时完成 FaCE 评分。
在就诊时，FGS 评分与 FaCE 总分呈正相关（ρ=0.63，P=0.002）。然而，当单独分析 FaCE 评分的各个领域时，面部舒适度和泪液评分的领域与 FGS 没有显著相关性。同样，在随访结束时，FGS 和 FaCE 评分的面部舒适度、泪液控制和社会功能领域的改善量之间没有显著且低的相关性（P<0.05）。
这是第一项比较贝尔面瘫患者 FGS 和 FaCE 评分的纵向研究。我们的发现表明，如果没有基于患者的生活质量评估，如 FaCE，医生评分的仪器可能会忽略某些面部残疾的功能方面，这些仪器主要关注面部美观。
4 级。
