[Skip to Navigation]
Views 584
Citations 0
Original Investigation
July 1, 2021

Associations Between Clinician-Graded Facial Function and Patient-Reported Quality of Life in Adults With Peripheral Facial Palsy: A Systematic Review and Meta-analysis

Author Affiliations
  • 1University of Groningen, Department of Plastic Surgery, University Medical Center Groningen, Groningen, the Netherlands
  • 2University of Groningen, Center for Rehabilitation, Groningen, University Medical Center Groningen, Groningen, the Netherlands
  • 3University of Groningen, Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, Groningen, the Netherlands
JAMA Otolaryngol Head Neck Surg. Published online July 1, 2021. doi:10.1001/jamaoto.2021.1290
Key Points

Question  What is the association between clinician-graded facial function and patient-reported quality of life in adults (≥18 years) with peripheral facial palsy?

Findings  This systematic review and meta-analysis of 23 studies including 3746 participants found that associations between clinician-graded facial function and patient-reported quality of life were overall low to moderate. Facial palsy severity was associated more with the physical than social function of quality of life.

Meaning  This study noted that quality of life can only moderately be estimated by facial function, suggesting that, in both clinical practice and research, factors other than clinician-graded facial function need to be taken into account.

Abstract

Importance  Understanding how the quality of life of adults (≥18 years) with peripheral facial palsy can be estimated using clinician measures of facial function and patient-reported variables might aid in counseling patients and in conducting research.

Objectives  To analyze associations between clinician-graded facial function and patient-reported quality of life in adults with peripheral facial palsy, compare associations between facial function and the physical and social functions of quality of life, and examine factors that might influence the associations.

Data Sources  A literature search was conducted in PubMed, Embase, CINAHL, Web of Science and PsycInfo on June 4, 2020, with no restrictions on the start date.

Study Selection  Twenty-three studies reporting an association between clinician-graded facial function and patient-reported quality of life in adults with peripheral facial palsy were included. Facial function instruments included the House-Brackmann, Sunnybrook Facial Grading System, and electronic clinician-graded facial function assessment. Quality-of-life instruments included the Facial Disability Index and Facial Clinimetric Evaluation Scale.

Data Extraction and Synthesis  Data extraction and qualitative synthesis were performed according to the Meta-analysis of Observational Studies in Epidemiology guidelines. Record screening, data extraction, and quality assessments were done by 2 researchers independently. Data were pooled using random-effects models.

Main Outcomes and Measures  The main outcome was the association between facial function and quality of life, quantified by Pearson r, Spearman ρ, or regression analysis.

Results  In total, 23 studies (3746 participants) were included. In the 21 studies that reported on the sex of the cohorts, there were 2073 women (57.3%). Mean or median age ranged from 21 to 64 years and mean or median duration of palsy ranged from newly diagnosed to 12 years. Bell palsy (n = 1397), benign tumor (n = 980), and infection (n = 257) were the most common etiologic factors. Pooled correlation coefficients were 0.424 (95% CI, 0.375-0.471) to 0.533 (95% CI, 0.447-0.610) between facial function and Facial Clinimetric Evaluation Scale total, 0.324 (95% CI, 0.128-0.495) to 0.397 (95% CI, 0.242-0.532) between facial function and Facial Clinimetric Evaluation Scale social function, 0.423 (95% CI, 0.322-0.514) to 0.605 (95% CI, −0.124-0.910) between facial function and Facial Disability Index physical function, and 0.166 (95% CI, 0.044-0.283) to 0.208 (95% CI, 0.031-0.373) between facial function and Facial Disability Index social function.

Conclusions and Relevance  Associations noted in this systematic review and meta-analysis were overall low to moderate, suggesting that only a small part of quality of life is explained by facial function. Associations were higher between facial function and physical function than social function of quality of life.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×