Facteurs prédictifs des séquelles de paralysie faciale idiopathique : suivi longitudinal

Abstract

Facial palsy can be assessed using objective and subjective tools. The main purpose of this work was to use these tools to determine at 12months the percentage of patients with sequelae and to specify the type of sequelae. Twenty-three patients with facial palsy were followed in this prospective and longitudinal study. They have been evaluated every 3months during a year with the House and Brackmann grading scale and the Sunnybrook Facial Grading System. At 12months, group A was composed of patients with complete recovery and group B, patients with sequelae. At 3months, in patients of group B, the House-Brackmann grading scale (P=0.0134), the Sunnybrook Facial Grading System global score (P=0.0283) and dynamic score (P=0.0148) were lower than group A. Moreover, the movement "brow lift" (P=0.0181) seems to be relevant to predict follow-up. Synkinesis on "brow lift" (P=0.0270) and the treatment delay (P=0.0384) increased for group B. Sex, age, paralyzed side and recurrence of facial palsy had no influence. Objective and subjective tools determine thresholds and predictive scores of recovery with sequelae at 1year. Nevertheless, it is relevant to assess clinically specific facial movements, such as "brow lift", to specify a recovery potential and to predict sequelae a year after the onset of facial palsy. As the treatment delay influences recovery, drug treatment should be recommended as early as possible.