Association of Socioeconomic, Personality, and Mental Health Factors With Health-Related Quality of Life in Patients With Facial Palsy | Facial Nerve | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 34.239.157.140. Please contact the publisher to request reinstatement.
1.
Gordin  E, Lee  TS, Ducic  Y, Arnaoutakis  D.  Facial nerve trauma: evaluation and considerations in management.   Craniomaxillofac Trauma Reconstr. 2015;8(1):1-13. doi:10.1055/s-0034-1372522 PubMedGoogle ScholarCrossref
2.
Tavares-Brito  J, van Veen  MM, Dusseldorp  JR, Bahmad  F  Jr, Hadlock  TA.  Facial palsy–specific quality of life in 920 patients: correlation with clinician-graded severity and predicting factors.   Laryngoscope. 2019;129(1):100-104. doi:10.1002/lary.27481PubMedGoogle ScholarCrossref
3.
Fattah  AY, Gurusinghe  ADR, Gavilan  J,  et al; Sir Charles Bell Society.  Facial nerve grading instruments: systematic review of the literature and suggestion for uniformity.   Plast Reconstr Surg. 2015;135(2):569-579. doi:10.1097/PRS.0000000000000905 PubMedGoogle ScholarCrossref
4.
Kleiss  IJ, Hohman  MH, Susarla  SM, Marres  HA, Hadlock  TA.  Health-related quality of life in 794 patients with a peripheral facial palsy using the FaCE Scale: a retrospective cohort study.   Clin Otolaryngol. 2015;40(6):651-656. doi:10.1111/coa.12434 PubMedGoogle ScholarCrossref
5.
Nellis  JC, Ishii  M, Byrne  PJ, Boahene  KDO, Dey  JK, Ishii  LE.  Association among facial paralysis, depression, and quality of life in facial plastic surgery patients.   JAMA Facial Plast Surg. 2017;19(3):190-196. doi:10.1001/jamafacial.2016.1462 PubMedGoogle ScholarCrossref
6.
Kahn  JB, Gliklich  RE, Boyev  KP, Stewart  MG, Metson  RB, McKenna  MJ.  Validation of a patient-graded instrument for facial nerve paralysis: the FaCE Scale.   Laryngoscope. 2001;111(3):387-398. doi:10.1097/00005537-200103000-00005 PubMedGoogle ScholarCrossref
7.
VanSwearingen  JM, Brach  JS.  The Facial Disability Index: reliability and validity of a disability assessment instrument for disorders of the facial neuromuscular system.   Phys Ther. 1996;76(12):1288-1298. doi:10.1093/ptj/76.12.1288 PubMedGoogle ScholarCrossref
8.
Baumann  I, Polligkeit  J, Blumenstock  G, Mauz  PS, Zalaman  IM, Maassen  MM.  Quality of life after unilateral acoustic neuroma surgery via middle cranial fossa approach.   Acta Otolaryngol. 2005;125(6):585-591. doi:10.1080/00016480510026935 PubMedGoogle ScholarCrossref
9.
Cross  T, Sheard  CE, Garrud  P, Nikolopoulos  TP, O’Donoghue  GM.  Impact of facial paralysis on patients with acoustic neuroma.   Laryngoscope. 2000;110(9):1539-1542. doi:10.1097/00005537-200009000-00024 PubMedGoogle ScholarCrossref
10.
Lassaletta  L, Alfonso  C, Del Rio  L, Roda  JM, Gavilan  J.  Impact of facial dysfunction on quality of life after vestibular schwannoma surgery.   Ann Otol Rhinol Laryngol. 2006;115(9):694-698. doi:10.1177/000348940611500908 PubMedGoogle ScholarCrossref
11.
Lucchetti  G, De Rossi  J, Gonçalves  JPB, Lucchetti  ALG.  Peripheral facial palsy: does patients’ religiousness matter for the otorhinolaryngologist?   J Relig Health. 2016;55(3):856-861. doi:10.1007/s10943-015-0062-1 PubMedGoogle ScholarCrossref
12.
Fu  L, Bundy  C, Sadiq  SA.  Psychological distress in people with disfigurement from facial palsy.   Eye (Lond). 2011;25(10):1322-1326. doi:10.1038/eye.2011.158 PubMedGoogle ScholarCrossref
13.
Saadi  R, Shokri  T, Schaefer  E, Hollenbeak  C, Lighthall  JG.  Depression rates after facial paralysis.   Ann Plast Surg. 2019;83(2):190-194. doi:10.1097/SAP.0000000000001908 PubMedGoogle ScholarCrossref
14.
van Veen  MM, Quatela  O, Tavares-Brito  J,  et al.  Patient-perceived severity of synkinesis reduces quality of life in facial palsy: a cross-sectional analysis in 92 patients.   Clin Otolaryngol. 2019;44(3):483-486. doi:10.1111/coa.13322 PubMedGoogle ScholarCrossref
15.
van Veen  MM, Tavares-Brito  J, van Veen  BM,  et al.  Association of regional facial dysfunction with facial palsy–related quality of life.   JAMA Facial Plast Surg. 2019;21(1):32-37.PubMedGoogle ScholarCrossref
16.
Israelsson  J, Thylén  I, Strömberg  A, Bremer  A, Årestedt  K.  Factors associated with health-related quality of life among cardiac arrest survivors treated with an implantable cardioverter-defibrillator.   Resuscitation. 2018;132:78-84. doi:10.1016/j.resuscitation.2018.09.002 PubMedGoogle ScholarCrossref
17.
Luttik  ML, Jaarsma  T, Veeger  N, van Veldhuisen  DJ.  Marital status, quality of life, and clinical outcome in patients with heart failure.   Heart Lung. 2006;35(1):3-8. doi:10.1016/j.hrtlng.2005.08.001 PubMedGoogle ScholarCrossref
18.
Gosling  SD, Rentfrow  PJ, Swann  WB  Jr.  A very brief measure of the Big-Five personality domains.   J Res Pers. 2003;37(6):504-528. doi:10.1016/S0092-6566(03)00046-1 Google ScholarCrossref
19.
Koenig  H, Parkerson  GR  Jr, Meador  KG.  Religion index for psychiatric research.   Am J Psychiatry. 1997;154(6):885-886. doi:10.1176/ajp.154.6.885b PubMedGoogle Scholar
20.
Zigmond  AS, Snaith  RP.  The Hospital Anxiety and Depression Scale.   Acta Psychiatr Scand. 1983;67(6):361-370. doi:10.1111/j.1600-0447.1983.tb09716.x PubMedGoogle ScholarCrossref
21.
Huang  IC, Lee  JL, Ketheeswaran  P, Jones  CM, Revicki  DA, Wu  AW.  Does personality affect health-related quality of life? a systematic review.   PLoS One. 2017;12(3):e0173806. doi:10.1371/journal.pone.0173806 PubMedGoogle Scholar
22.
Afshar  H, Roohafza  HR, Keshteli  AH, Mazaheri  M, Feizi  A, Adibi  P.  The association of personality traits and coping styles according to stress level.   J Res Med Sci. 2015;20(4):353-358.PubMedGoogle Scholar
23.
Volk  GF, Granitzka  T, Kreysa  H, Klingner  CM, Guntinas-Lichius  O.  Initial severity of motor and non-motor disabilities in patients with facial palsy: an assessment using patient-reported outcome measures.   Eur Arch Otorhinolaryngol. 2017;274(1):45-52. doi:10.1007/s00405-016-4018-1 PubMedGoogle ScholarCrossref
24.
Strobel  L, Renner  G.  Quality of life and adjustment in children and adolescents with Moebius syndrome: evidence for specific impairments in social functioning.   Res Dev Disabil. 2016;53-54:178-188. doi:10.1016/j.ridd.2016.02.005 PubMedGoogle ScholarCrossref
25.
Saito  DM, Cheung  SW.  A comparison of facial nerve disability between patients with Bell’s palsy and vestibular schwannoma.   J Clin Neurosci. 2010;17(9):1122-1125. doi:10.1016/j.jocn.2010.01.019 PubMedGoogle ScholarCrossref
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
    Original Investigation
    February 13, 2020

    Association of Socioeconomic, Personality, and Mental Health Factors With Health-Related Quality of Life in Patients With Facial Palsy

    Author Affiliations
    • 1Department of Plastic Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
    • 2Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
    • 3Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
    JAMA Otolaryngol Head Neck Surg. 2020;146(4):331-337. doi:10.1001/jamaoto.2019.4559
    Key Points

    Question  What is the association of socioeconomic, personality, and mental health factors with health-related quality of life in patients with facial palsy?

    Findings  This cross-sectional study found that health-related quality of life among 121 patients with facial palsy at a tertiary referral center for facial reanimation surgery appeared to be associated with age, bilateral facial palsy, severity of facial palsy, mental distress, and the personality traits of extraversion, conscientiousness, and emotional stability.

    Meaning  It is important to assess socioeconomic, personality, and mental health factors when investigating health-related quality of life before and after facial palsy intervention to better interpret the results and evaluate treatment.

    Abstract

    Importance  Knowledge of factors associated with health-related quality of life in patients with facial palsy may aid in better interpreting outcomes of research and treatment.

    Objective  To identify factors associated with health-related quality of life in patients with facial palsy.

    Design, Setting, and Participants  The inclusion period for participants in this cross-sectional study at the University Medical Center Groningen, a tertiary referral center for facial reanimation surgery, was March 1 to June 1, 2019. Patients aged at least 18 years with facial palsy who had undergone surgery for facial palsy between January 1, 2007, and January 1, 2018, and patients visiting the outpatient clinic of the University of Groningen Department of Plastic Surgery for their facial palsy between March 1 and June 1, 2019, were also asked to participate. Of 276 patients invited, 145 gave informed consent. Twenty patients did not respond after consent, 3 patients withdrew from the study, and 1 patient was wrongly included.

    Main Outcomes and Measures  Health-related quality of life was measured using the Facial Clinimetric Evaluation Scale and the Facial Disability Index (physical score and social score). Facial function was assessed with the Sunnybrook Facial Grading System. Other variables were investigated using validated questionnaires, including the Duke University Religion Index, Ten-Item Personality Inventory, and Hospital Anxiety and Depression Scale. Multivariable linear regression analyses with stepwise backward selection were performed to identify associations with health-related quality of life. Because 44 Sunnybrook composite scores were missing, a sensitivity analysis was performed that excluded the Sunnybrook composite scores from the multivariable analysis.

    Results  In total, 121 patients with facial palsy were included; their median age was 62 years (interquartile range, 48-71 years), and 63 (52%) were women. Sunnybrook composite score (β = 0.4; 95% CI, 0.2-0.5), extraversion (β = 2.6; 95% CI, 0.4-4.8), and anxiety (β = −2.4; 95% CI, −4.1 to −0.8) were associated with the Facial Clinimetric Evaluation Scale total score (R2 = 0.380; 95% CI, 0.212-0.548). The Sunnybrook composite score was associated with the Facial Disability Index physical score (β = 0.2; 95% CI, 0.0-0.4) (R2 = 0.084; 95% CI, −0.037 to 0.205). Bilateral facial palsy (β = −21.2; 95% CI, −32.3 to −10.1), extraversion (β = 2.7; 95% CI, 1.3-4.1), conscientiousness (β = 2.7; 95% CI, 0.2-5.2), emotional stability (β = 3.3; 95% CI, 1.7-4.8), and depression (β = −1.3; 95% CI, −2.5 to −0.1) were associated with the Facial Disability Index social score (R2 = 0.400; 95% CI, 0.262-0.538). In the sensitivity analysis, the Sunnybrook composite score was associated with age (Spearman ρ = −0.252).

    Conclusions and Relevance  Bilateral facial palsy, age, severity of facial palsy, mental distress, and personality traits should be taken into account in future research and treatment of patients with facial palsy.

    ×