Facial Palsy Assessment Methodologies Not Consistent

Which assessment methodologies are currently employed by those involved in the care of patients with facial palsy?

Background: Facial palsy arises from myriad clinical conditions, affects patients of all ages, and greatly impacts interpersonal communication and perception of individuals who experience the condition. It has been difficult to find a uniform manner to document and communicate the objective and subjective impact of facial palsy among professionals. The Sir Charles Bell Society (SCBS) brings together international healthcare professionals involved in managing disorders of the facial nerve.

Study design: A 10-question online questionnaire.

Setting: One hundred fifty-one members of the SCBS, an international group of professionals dedicated to the care of patients with facial palsy, were surveyed.

Synopsis: Eighty-three complete responses were received. Ninety-five percent of respondents used facial assessment scales (most common: the House-Brackmann and Sunnybrook scales); many respondents used more than one scale. The most common method used for documenting synkinesis was the Sunnybrook scale; several respondents used more than one recording method. Forty-two percent of respondents did not use a specific patient-reported outcome measure for facial palsy, 31% used the facial clinimetric evaluation (FaCE) scale, and the remaining 27% used other methods. Additional methods were used to determine psychological and social functioning by 46% of respondents. Still photography as an objective record of the facial aesthetic was used by all but one respondent, and videography was used by 82%. The most common views were repose, full smile, raised eyebrows, gentle eye closure, puckering the lips to make an “oo” sound, tight eye closure, gentle smile, snarl, and nasal base view. Three-dimensional imaging was used by 18% of respondents. Limitations include the fact that this survey may not characterize the typical healthcare professional with an interest in facial palsy care and does not take into account practitioners who treat facial palsy as only a small part of a practice.

Bottom line: There is significant heterogeneity in assessments used by clinicians, which impedes straightforward comparisons of outcomes among practitioners.

Citation: Fattah AY, Gavilan J, Hadlock TA, et al. Survey of methods of facial palsy documentation in use by members of the Sir Charles Bell Society. Laryngoscope. 2014;124:2247-2251.

—Reviewed by Amy Eckner