Fu Wei, Liang Jiantao, Li Mingchu, Song Gang, Guo Jing, Zheng Hongyu, Zhang Xiaolei
Department of Neurosurgery, XuanWu Hospital, Capital Medical University, Beijing, China.
International Neuroscience Institute (China-INI), Beijing, China.
Heliyon. 2024 Jul 23;10(15):e35060. doi: 10.1016/j.heliyon.2024.e35060. eCollection 2024 Aug 15.
After vestibular schwannoma (VS) surgery, some patients exhibit different degrees of peripheral facial paralysis, which can seriously affect their quality of life. The recovery of facial nerve function after surgery typically takes a considerable amount of time; therefore, the recovery of facial nerve function depends mainly on the rehabilitation treatment and nursing after discharge. In the past, we implemented conventional paralysis rehabilitation nursing program for patients with facial paralysis due to VS surgery. However, several patients with facial paralysis have bad compliance and do not achieve ideal facial nerve function recovery. Therefore, this study aimed to investigate whether modified facial paralysis rehabilitation nursing improves the effectiveness of rehabilitation of facial paralysis after VS surgery by analysing the clinical data of patients.
We screened the patients with facial paralysis after VS surgery from December 2019 to May 2023. The patients were divided into the conventional and modified groups based on the different nursing programs (conventional vs. modified facial paralysis rehabilitation nursing program) to compare the differences in facial nerve function, quality of life of patients, and compliance of rehabilitation between the two groups.
We analysed 128 patients with facial paralysis after VS surgery who met the inclusion and exclusion criteria; 65 and 63 patients in the conventional and modified group, respectively. The number of patients in the modified group with House-Brackmann grade changes >0 in facial nerve function was significantly higher than that in the conventional group 3 months after surgery (82.5 % vs 63.1 %, p = 0.01). Except for the lacrimal control score, the mean scores of the Chinese version of the FaCE scale were significantly higher in the modified group than those in the conventional group at 1 and 3 months postoperatively.
The modified facial paralysis rehabilitation nursing, i.e., integrated use of facial expressive muscle exercises and facial massage with video-assisted education, substantially improved the facial nerve function, quality of life, and compliance of rehabilitation nursing of patients with facial paralysis after VS surgery.
前庭神经鞘瘤（VS）手术后，部分患者会出现不同程度的周围性面瘫，严重影响其生活质量。术后面神经功能的恢复通常需要相当长的时间；因此，面神经功能的恢复主要依赖于出院后的康复治疗与护理。过去，我们对VS手术所致面瘫患者实施常规面瘫康复护理方案。然而，部分面瘫患者依从性差，未实现理想的面神经功能恢复。因此，本研究旨在通过分析患者的临床资料，探讨改良面瘫康复护理是否能提高VS手术后面瘫康复的效果。
我们筛选了2019年12月至2023年5月期间VS手术后的面瘫患者。根据不同的护理方案（常规面瘫康复护理方案与改良面瘫康复护理方案）将患者分为常规组和改良组，比较两组面神经功能、患者生活质量及康复依从性的差异。
我们分析了128例符合纳入和排除标准的VS手术后面瘫患者；常规组和改良组分别有65例和63例患者。术后3个月，改良组面神经功能House-Brackmann分级变化>0的患者数量显著高于常规组（82.5%对63.1%，p = 0.01）。术后1个月和3个月，除泪液控制评分外，改良组中文版FaCE量表的平均得分显著高于常规组。
改良面瘫康复护理，即综合运用面部表情肌锻炼、面部按摩及视频辅助教育，显著改善了VS手术后面瘫患者的面神经功能、生活质量及康复护理依从性。
