Volk Gerd Fabian, Granitzka Thordis, Kreysa Helene, Klingner Carsten M, Guntinas-Lichius Orlando
Department of Otorhinolaryngology, Jena University Hospital, Lessingstrasse 2, 07740, Jena, Germany.
Facial Nerve Center, Jena University Hospital, Jena, Germany.
Eur Arch Otorhinolaryngol. 2017 Jan;274(1):45-52. doi: 10.1007/s00405-016-4018-1. Epub 2016 Apr 4.
Patients with facial palsy (FP) not only suffer from their facial movement disorder, but also from social and psychological disabilities. These can be assessed by patient-reported outcome measures (PROMs) like the quality-of-life Short-Form 36 Item Questionnaire (SF36) or FP-specific instruments like the Facial Clinimetric Evaluation Scale (FaCE) or the Facial Disability Index (FDI). Not much is known about factors influencing PROMs in patients with FP. We identified predictors for baseline SF36, FaCE, and FDI scoring in 256 patients with unilateral peripheral FP using univariate correlation and multivariate linear regression analyses. Mean age was 52 ± 18 years. 153 patients (60 %) were female. 90 patients (31 %) and 176 patients (69 %) were first seen <90 or >90 days after onset, respectively, i.e., with acute or chronic FP. House-Brackmann grading was 3.9 ± 1.4. FaCE subscores varied from 41 ± 28 to 71 ± 26, FDI scores from 65 ± 20 to 70 ± 22, and SF36 domains from 52 ± 20 to 80 ± 24. Older age, female gender, higher House-Brackmann grading, and initial assessment >90 days after onset were independent predictors for lower FaCE subscores and partly for lower FDI subscores (all p < 0.05). Older age and female gender were best predictors for lower results in SF36 domains. Comorbidity was associated with lower SF General health perception and lower SF36 Emotional role (all p < 0.05). Specific PROMs reveal that older and female patients and patients with chronic FP suffer particularly from motor and non-motor disabilities related to FP. Comorbidity unrelated to the FP could additionally impact the quality of life of patients with FP.
面瘫（FP）患者不仅遭受面部运动障碍之苦，还面临社交和心理障碍。这些可通过患者报告结局指标（PROMs）进行评估，如生活质量简表36项问卷（SF36），或面瘫特异性工具，如面部临床计量评估量表（FaCE）或面部残疾指数（FDI）。关于影响面瘫患者PROMs的因素，人们了解得并不多。我们通过单变量相关性分析和多变量线性回归分析，确定了256例单侧周围性面瘫患者基线SF36、FaCE和FDI评分的预测因素。平均年龄为52±18岁。153例患者（60%）为女性。分别有90例患者（31%）和176例患者（69%）在发病后<90天或>90天首次就诊，即急性或慢性面瘫。House - Brackmann分级为3.9±1.4。FaCE子评分从41±28到71±26不等，FDI评分从65±20到70±22不等，SF36各领域评分从52±20到80±24不等。年龄较大、女性、较高的House - Brackmann分级以及发病后>90天进行初始评估是FaCE子评分较低以及部分FDI子评分较低的独立预测因素（所有p<0.05）。年龄较大和女性是SF36各领域得分较低的最佳预测因素。合并症与较低的SF总体健康感知和较低的SF36情感角色相关（所有p<0.05）。特定的PROMs显示，年龄较大和女性患者以及慢性面瘫患者尤其遭受与面瘫相关的运动和非运动障碍之苦。与面瘫无关的合并症可能会额外影响面瘫患者的生活质量。
