Chundury Rao V, D'Angelo Alexander S, Couch Steven M, Holds John B
*Department of Ophthalmology, Saint Louis University; †Department of Ophthalmology and Visual Sciences, Washington University; ‡Ophthalmic Plastic and Cosmetic Surgery, Inc.; and §Department of Otolaryngology/Head and Neck Surgery, Saint Louis University, St. Louis, Missouri, U.S.A.
Ophthalmic Plast Reconstr Surg. 2016 Mar-Apr;32(2):133-7. doi: 10.1097/IOP.0000000000000443.
To evaluate the Sunnybrook Facial Grading System (SFGS) and Facial Clinimetric Evaluation (FaCE) Scale Instrument outcomes when treating hemifacial spasm (HFS) with onabotulinumtoxinA.
An Institutional Review Board-approved retrospective review of records of 66 HFS patients treated with onabotulinumtoxinA. SFGS and FaCE surveys were completed prior to onabotulinumtoxinA therapy and at 1 month follow up. Surveys were analyzed for differences using paired Student t tests, with statistical significance set at p < 0.05. Correlations were determined using Spearman correlation (rs), with coefficients of ≥0.40 or ≤-0.40 considered significant.
There were 22 complete data sets. SFGS composite score improved from mean, 56.9 (SD, 12.3) to 63.6 (SD, 12.3), p < 0.01. SFGS subdomain synkinesis score significantly improved (p < 0.01). The FaCE scale subdomain oral function significantly worsened (p = 0.05). The Δ pre-/post-SFGS composite score did not correlate with the Δ pre-/post-FaCE composite score (rs = 0.24). There was a significant positive correlation between SFGS composite score and FaCE social function score (rs = 0.462, p = 0.03) and between SFGS voluntary movement score and FaCE social function score (rs = 0.477, p = 0.03). Subgroup analysis of single FaCE questions demonstrated no statistical change in subjective dry eye (p = 0.30).
There was an improvement in social functioning in treated HFS patients, which positively correlated with improvement in overall objective voluntary facial movement. There was no statistical difference in subjective dry eye symptoms. The overall SFGS composite score improved following treatment of HFS with botulinum toxin. This information can be used when counseling expected outcomes in HFS patients treated with onabotulinumtoxinA.
评估在使用A型肉毒毒素治疗半面痉挛（HFS）时，桑尼布鲁克面部分级系统（SFGS）和面部临床计量评估（FaCE）量表工具的结果。
对66例接受A型肉毒毒素治疗的HFS患者的记录进行机构审查委员会批准的回顾性研究。在A型肉毒毒素治疗前和随访1个月时完成SFGS和FaCE调查。使用配对学生t检验分析调查结果的差异，设定统计学显著性为p < 0.05。使用Spearman相关性（rs）确定相关性，系数≥0.40或≤ -0.40被认为具有显著性。
有22个完整数据集。SFGS综合评分从平均56.9（标准差，12.3）提高到63.6（标准差，12.3），p < 0.01。SFGS子领域联带运动评分显著改善（p < 0.01）。FaCE量表子领域口腔功能显著恶化（p = 0.05）。SFGS综合评分前后差值与FaCE综合评分前后差值不相关（rs = 0.24）。SFGS综合评分与FaCE社会功能评分之间存在显著正相关（rs = 0.462，p = 0.03），SFGS自主运动评分与FaCE社会功能评分之间也存在显著正相关（rs = 0.477，p = 0.03）。对单个FaCE问题的亚组分析显示主观干眼无统计学变化（p = 0.30）。
接受治疗的HFS患者的社会功能有所改善，这与整体客观自主面部运动的改善呈正相关。主观干眼症状无统计学差异。用肉毒毒素治疗HFS后，SFGS综合评分总体有所提高。这些信息可用于向接受A型肉毒毒素治疗的HFS患者咨询预期结果时。
