Prospective evaluation of quality-of-life improvement after correction of the alar base in the flaccidly paralyzed face.

Abstract

Nasal valve collapse caused by facial palsy is an often overlooked but disturbing sequela of flaccid facial paralysis. To prospectively study the effect of fascia lata sling placement for correction of external nasal valve compromise in patients with flaccid facial paralysis, using a validated disease-specific quality-of-life outcome survey. This was a prospective study of 68 patients from March 2009 to December 2013 who underwent fascia lata sling placement for correction of external nasal valve compromise. Fascia lata sling placement for the correction of external nasal valve compromise . Nasal Obstruction Symptom Evaluation (NOSE) scale. Sixty-eight disease-specific quality-of-life determinations were performed using the NOSE scale. Ratings were ascertained preoperatively and postoperatively. Sixty patients completed a NOSE scale prior to surgical intervention, and 40 completed the survey after intervention. There was a statistically significant difference in NOSE scores after fascia lata sling placement The mean preoperative NOSE score was 37.6 (27.1), and the mean postoperative score was 16.6 (17.37) (Wilcoxon signed-rank test; P < .001). All patients had improvement in their nasal obstruction, which persisted uniformly in follow-up. The nasal valve is a zone that has historically been neglected, despite the fact that a highly effective surgical solution has existed for decades. We highlight the significance of nasal valve dysfunction in patients with flaccid facial paralysis, demonstrate a quantitative benefit in disease-specific quality of life after fascia late sling placement for external nasal valve compromise, and suggest an updated treatment algorithm. This method offers a predictably successful, straightforward surgical solution to an overlooked functional problem in the patient with flaccid facial paralysis. 4.