Abstract
PurposeTo evaluate the long-term (minimum of 2 years from the palsy onset) outcome of pediatric facial palsy by patient questionnaire and face-to-face assessment by the Sunnybrook facial grading system, House–Brackmann grading system, and Facial Nerve Grading System 2.0. To compare the outcome results of self-assessment with the face-to-face assessment. To assess the applicability of the grading scales. To assess the palsy recurrence rate (minimum of a 10-year follow-up).Methods46 consecutive pediatric facial palsy patients: 38 (83%) answered the questionnaire and 25 (54%) attended a follow-up visit. Chart review of 43 (93%) after a minimum of 10 years for the facial palsy recurrence rate assessment.ResultsOf the 25 patients assessed face-to-face, 68% had totally recovered but 35% of them additionally stated subjective sequelae in a self-assessment questionnaire. Good recovery was experienced by 80% of the patients. In a 10-year follow-up, 14% had experienced palsy recurrence, only one with a known cause. Sunnybrook was easy and logical to use, whereas House–Brackmann and the Facial Nerve Grading System 2.0 were incoherent.ConclusionsFacial palsy in children does not heal as well as traditionally claimed if meticulously assessed face-to-face. Patients widely suffer from subjective sequelae affecting their quality of life. Palsy recurrence was high, much higher than previously reported even considering the whole lifetime. Of these three grading systems, Sunnybrook was the most applicable.
Highlights
If peripheral facial palsy (FP) does not recover fully, cosmetic drawback for the patient is obvious, but the effect on vision, eating, drinking, psychological issues, self-esteem, and quality of life are overlooked, well established [1]
The recruitment letter contained an invitation to come for a one-time face-to-face FP grading session and a questionnaire for self/caregiver-assessment of the long-term FP outcome, recovery, and possible sequelae results; it included the Synkinesis Assessment Questionnaire (SAQ) [21] (Tables 4, 5)
Have you/your child fully recovered from facial palsy? 5
Summary
If peripheral facial palsy (FP) does not recover fully, cosmetic drawback for the patient is obvious, but the effect on vision, eating, drinking, psychological issues, self-esteem, and quality of life are overlooked, well established [1]. This applies to situations where voluntary muscle function has recovered quite well but the patient is affected by sequelae [2, 3].
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