Pennsylvania State University, College of Medicine, Hershey, PA.
Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR.
J Craniofac Surg. 2022 Sep 1;33(6):1754-1761. doi: 10.1097/SCS.0000000000008725. Epub 2022 Aug 11.
Advances in operative management, minimally invasive procedures, and physical therapy have allowed for dramatic improvements in functional and cosmetic outcomes in patients with facial paralysis. Our goal was to evaluate the current trends and practice patterns in the diagnosis and management of facial paralysis by provider demographics.
An electronic questionnaire was distributed to members of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). Practice patterns in the diagnosis and treatment were compared by level of training (fellowship-trained facial plastic and reconstructive surgeon versus non-fellowship trained), practice type (academic and private), practice length, patient volume, and presence of a dedicated facial nerve clinic. The bivariate associations of the outcome variables and the stratification factors were analyzed using 2-way contingency tables and Fisher's exact tests.
The survey was sent to 1129 members of the AAFPRS. The response rate was 11.7% (n=132). Most respondents were fellowship-trained surgeons (79%) in the academic setting (55%), and most have been in practice for more than 10 years (53%). Practice setting and patient volume were the factors most associated with significant variations in management, including the use of facial paralysis grading scales, photography/videography, patient-reported outcome metrics, as well as differences in both noninvasive and surgical management.
Based on the present study, several physician demographic factors may play a role in choosing which diagnostic and treatment options are employed for facial paralysis, with practice setting and patient volume appearing to be the 2 variables associated with the most significant differences.
手术管理、微创手术和物理疗法的进步使面瘫患者的功能和美容效果得到了显著改善。我们的目标是通过医生的人口统计学资料评估面瘫的诊断和管理的当前趋势和实践模式。
向美国面部整形与重建外科学会（AAFPRS）的成员发放了电子问卷。通过培训水平（面部整形和重建外科 fellowship培训医师与非 fellowship 培训医师）、实践类型（学术和私人）、实践年限、患者量和是否有专门的面神经诊所，比较诊断和治疗中的实践模式。使用双向列联表和 Fisher 确切检验分析结果变量和分层因素的二变量关联。
该调查发送给了 AAFPRS 的 1129 名成员。回复率为 11.7%（n=132）。大多数受访者是在学术环境中接受过 fellowship培训的外科医生（79%），其中大多数人已经从业超过 10 年（53%）。实践环境和患者量是管理中差异最显著的因素，包括面瘫分级量表、摄影/录像、患者报告的结果指标，以及非侵入性和手术管理的差异。
根据本研究，一些医生的人口统计学因素可能会影响面瘫的诊断和治疗选择，实践环境和患者量似乎是与差异最显著相关的两个变量。
