Facial Plast Surg 2024; 40(04): 400-406
DOI: 10.1055/s-0044-1779046
Original Article

Evaluation of the Patient with Facial Palsy: A Multidisciplinary Approach

Hala Kanona
1   The Royal National ENT Hospital, University College London Hospitals, London, United Kingdom
,
Shakeel R. Saeed
1   The Royal National ENT Hospital, University College London Hospitals, London, United Kingdom
2   The Royal National ENT Hospital and National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom
,
Premjit Randhawa
1   The Royal National ENT Hospital, University College London Hospitals, London, United Kingdom
,
Rebecca Kimber
2   The Royal National ENT Hospital and National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom
,
Anne Rodger
2   The Royal National ENT Hospital and National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom
,
Sherif Khalil
1   The Royal National ENT Hospital, University College London Hospitals, London, United Kingdom
2   The Royal National ENT Hospital and National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom
,
Peter Andrews
1   The Royal National ENT Hospital, University College London Hospitals, London, United Kingdom
2   The Royal National ENT Hospital and National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom
› Institutsangaben

Abstract

This article aims to provide an overview of the management of facial palsy within a multidisciplinary team setting and discusses considerations used to develop patient-specific management plans. The national landscape of facial function services is also discussed including suggestions on what may enable a more equitable and sustainable service for the future.



Publikationsverlauf

Artikel online veröffentlicht:
01. Februar 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Rowlands S, Hooper R, Hughes R, Burney P. The epidemiology and treatment of Bell's palsy in the UK. Eur J Neurol 2002; 9 (01) 63-67
  • 2 Cubbon M. Delegation of NHS England's direct commissioning functions to integrated care boards. 2022 . Accessed May 20, 2023 at: https://www.england.nhs.uk/commissioning/
  • 3 Jones CD, Ho W, Nduka C. UK national survey on facial palsy services. J Plast Reconstr Aesthet Surg 2021; 74 (05) 1101-1160
  • 4 Krishnan Santha K, Joseph S, Latheef S. et al. Dynamic smile reanimation in facial nerve palsy. J Korean Assoc Oral Maxillofac Surg 2020; 46 (02) 143-149
  • 5 Runge MS, Greganti MA. Netter's Internal Medicine. 2nd ed. Philadelphia, PA:: Elsevier;; 2009
  • 6 Gantz BJ, Rubinstein JT, Gidley P, Woodworth GG. Surgical management of Bell's palsy. Laryngoscope 1999; 109 (08) 1177-1188
  • 7 Jing SS, Thomas A, Nduka C. Variability in facial palsy service provisioning in the United Kingdom. Int J Surg 2014; 12 (02) 186-187
  • 8 Kanerva M, Poussa T, Pitkäranta A. Sunnybrook and House-Brackmann Facial Grading Systems: intrarater repeatability and interrater agreement. Otolaryngol Head Neck Surg 2006; 135 (06) 865-871
  • 9 Sadiq SA, Usmani HA, Saeed SR. Effectiveness of a multidisciplinary facial function clinic. Eye (Lond) 2011; 25 (10) 1360-1364
  • 10 Garcia RM, Hadlock TA, Klebuc MJ, Simpson RL, Zenn MR, Marcus JR. Contemporary solutions for the treatment of facial nerve paralysis. Plast Reconstr Surg 2015; 135 (06) 1025e-1046e
  • 11 Steinhäuser J, Volk GF, Thielker J. et al. Multidisciplinary care of patients with facial palsy: treatment of 1220 patients in a German Facial Nerve Center. J Clin Med 2022; 11 (02) 42
  • 12 Volk GF, Guntinas-Lichius O, Schaitkin BM. Clinical examination. In: Guntinas-Lichius O, Schaitkin BM. Facial Nerve Disorders and Diseases: Diagnosis and Management. Stuttgart Thieme Verlag; 2016: 32-56
  • 13 House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg 1985; 93 (02) 146-147
  • 14 Yen TL, Driscoll CL, Lalwani AK. Significance of House-Brackmann facial nerve grading global score in the setting of differential facial nerve function. Otol Neurotol 2003; 24 (01) 118-122
  • 15 O'Reilly BF, Soraghan JJ, McGrenary S, He S. Objective method of assessing and presenting the House-Brackmann and regional grades of facial palsy by production of a facogram. Otol Neurotol 2010; 31 (03) 486-491
  • 16 Miller MQ, Hadlock TA, Fortier E, Guarin DL. The Auto-eFACE: machine learning-enhanced program yields automated facial palsy assessment tool. Plast Reconstr Surg 2021; 147 (02) 467-474
  • 17 Hadlock TA, Urban LS. Toward a universal, automated facial measurement tool in facial reanimation. Arch Facial Plast Surg 2012; 14 (04) 277-282
  • 18 Gerós A, Horta R, Aguiar P. Facegram - objective quantitative analysis in facial reconstructive surgery. J Biomed Inform 2016; 61: 1-9
  • 19 Kleiss IJ, Hohman MH, Quatela OE, Marres HA, Hadlock TA. Computer-assisted assessment of ocular synkinesis: a comparison of methods. Laryngoscope 2013; 123 (04) 879-883
  • 20 Derakhshan A, Miller MQ, Malka R, Gadkaree SK, Hadlock TA. Releasing the smile: depressor anguli oris excision in the context of managing nonflaccid facial palsy. Plast Reconstr Surg 2022; 149 (02) 261e-269e
  • 21 Lindsay RW, Bhama P, Hadlock TA. Quality-of-life improvement after free gracilis muscle transfer for smile restoration in patients with facial paralysis. JAMA Facial Plast Surg 2014; 16 (06) 419-424
  • 22 Guntinas-Lichius O, Volk GF, Olsen KD. et al. Facial nerve electrodiagnostics for patients with facial palsy: a clinical practice guideline. Eur Arch Otorhinolaryngol 2020; 277 (07) 1855-1874
  • 23 Phillips CD, Bubash LA. The facial nerve: anatomy and common pathology. Semin Ultrasound CT MR 2002; 23 (03) 202-217
  • 24 Burmeister HP, Baltzer PA, Dietzel M. et al. Identification of the nervus intermedius using 3T MR imaging. AJNR Am J Neuroradiol 2011; 32 (03) 460-464
  • 25 Mumtaz S, Jensen MB. Facial neuropathy with imaging enhancement of the facial nerve: a case report. Future Neurol 2014; 9 (06) 571-576
  • 26 Urban E, Volk GF, Geißler K. et al. Prognostic factors for the outcome of Bell's palsy: a cohort register-based study. Clin Otolaryngol 2020; 45 (05) 754-761
  • 27 Geißler K, Urban E, Volk GF, Klingner CM, Witte OW, Guntinas-Lichius O. Non-idiopathic peripheral facial palsy: prognostic factors for outcome. Eur Arch Otorhinolaryngol 2021; 278 (09) 3227-3235
  • 28 Butler DP, Morales DR, Johnson K, Nduka C. Facial palsy: when and why to refer for specialist care. Br J Gen Pract 2019; 69 (688) 579-580
  • 29 Guntinas-Lichius O, Finkensieper M. Facial nerve reconstruction. In: Guntinas-Lichius O, Schaitkin BM. Facial Nerve Disorders and Diseases: Diagnosis and Management. Stuttgart Thieme Verlag; 2016: 264-280
  • 30 Györi E, Przestrzelski C, Pona I. et al. Quality of life and functional assessment of facial palsy patients: a questionnaire study. Int J Surg 2018; 55: 92-97
  • 31 Walker DT, Hallam MJ, Ni Mhurchadha S, McCabe P, Nduka C. The psychosocial impact of facial palsy: our experience in one hundred and twenty six patients. Clin Otolaryngol 2012; 37 (06) 474-477
  • 32 Shokri T, Patel S, Ziai K, Harounian J, Lighthall JG. Facial synkinesis: a distressing sequela of facial palsy. Ear Nose Throat J 2021; 26: 1455613211054627
  • 33 Lundborg G, Rosén B. Hand function after nerve repair. Acta Physiol (Oxf) 2007; 189 (02) 207-217
  • 34 Guntinas-Lichius O, Straesser A, Streppel M. Quality of life after facial nerve repair. Laryngoscope 2007; 117 (03) 421-426
  • 35 Irintchev A, Angelov D. Applied basic science: improvement of nerve regeneration. In: Guntinas-Lichius O, Schaitkin BM. Facial Nerve Disorders and Diseases: Diagnosis and Management. Stuttgart Thieme Verlag; 2016: 23-30
  • 36 Hotton M, Huggons E, Hamlet C. et al. The psychosocial impact of facial palsy: A systematic review. Br J Health Psychol 2020; 25 (03) 695-727
  • 37 Hayler R, Clark J, Croxson G. et al. Sydney Facial Nerve Clinic: experience of a multidisciplinary team. ANZ J Surg 2020; 90 (05) 856-860
  • 38 Christophi G, Holland A, Rodger A, Kimber R. An expert opinion: facial rehabilitation: combining the science and art. Adv Clin Neurosci Rehabil 2020; 19 (04) 44-46
  • 39 Watson GJ, Glover S, Allen S, Irving RM. Outcome of facial physiotherapy in patients with prolonged idiopathic facial palsy. J Laryngol Otol 2015; 129 (04) 348-352
  • 40 Hovind H, Nielsen SL. Effect of massage on blood flow in skeletal muscle. Scand J Rehabil Med 1974; 6 (02) 74-77
  • 41 Szczepura A, Holliday N, Neville C. et al. Raising the digital profile of facial palsy: national surveys of patients' and clinicians' experiences of changing UK treatment pathways and views on the future role of digital technology. J Med Internet Res 2020; 22 (10) e20406
  • 42 Nigam PK, Nigam A. Botulinum toxin. Indian J Dermatol 2010; 55 (01) 8-14
  • 43 Patil S, Willett O, Thompkins T. et al. Botulinum toxin: pharmacology and therapeutic roles in pain states. Curr Pain Headache Rep 2016; 20 (03) 15
  • 44 Vaughan A, Copley A, Miles A. Physical rehabilitation of central facial palsy: a survey of current multidisciplinary practice. Int J Speech Lang Pathol 2022; 24 (06) 616-625
  • 45 Wittekindt C. Adjuvant treatment with botulinum toxin and fillers. In: Guntinas-Lichius O, Schaitkin BM. Facial Nerve Disorders and Diseases: Diagnosis and Management. Stuttgart Thieme Verlag; 2016: 329341
  • 46 Ranoux D, Gury C, Fondarai J, Mas JL, Zuber M. Respective potencies of Botox and Dysport: a double blind, randomised, crossover study in cervical dystonia. J Neurol Neurosurg Psychiatry 2002; 72 (04) 459-462
  • 47 Anderson TJ. Spasmodic torticollis. In: Moore P. ed. Handbook of Botulinum Toxin Treatment. Oxford, Blackwell Science, 1995: 103-30
  • 48 Sadiq SA, Khwaja S, Saeed SR. Botulinum toxin to improve lower facial symmetry in facial nerve palsy. Eye (Lond) 2012; 26 (11) 1431-1436
  • 49 Azuma T, Nakamura K, Takahashi M. et al. Mirror biofeedback rehabilitation after administration of single-dose botulinum toxin for treatment of facial synkinesis. Otolaryngol Head Neck Surg 2012; 146 (01) 40-45
  • 50 Azizzadeh B, Irvine LE, Diels J. et al. Modified selective neurectomy for the treatment of post-facial paralysis synkinesis. Plast Reconstr Surg 2019; 143 (05) 1483-1496
  • 51 Miller MQ, Hadlock TA. Deep dive into denervation: institutional experience with selective denervation in nonflaccid facial palsy. Facial Plast Surg Aesthet Med 2021; 23 (04) 241-247
  • 52 Ovaitt AK, Chweya CM, Flynn J. Selective neurectomy for nonflaccid facial palsy. Curr Opin Otolaryngol Head Neck Surg 2023; 31 (04) 244-247
  • 53 Cooper L, Lui M, Nduka C. Botulinum toxin treatment for facial palsy: a systematic review. J Plast Reconstr Aesthet Surg 2017; 70 (06) 833-841
  • 54 Ashley Z, Sutherland H, Russold MF. et al. Therapeutic stimulation of denervated muscles: the influence of pattern. Muscle Nerve 2008; 38 (01) 875-886
  • 55 Salmons S, Jarvis JC. Functional electrical stimulation of denervated muscles: an experimental evaluation. Artif Organs 2008; 32 (08) 597-603
  • 56 Tuncay F, Borman P, Taşer B, Ünlü İ, Samim E. Role of electrical stimulation added to conventional therapy in patients with idiopathic facial (Bell) palsy. Am J Phys Med Rehabil 2015; 94 (03) 222-228
  • 57 Manikandan N. Effect of facial neuromuscular re-education on facial symmetry in patients with Bell's palsy: a randomized controlled trial. Clin Rehabil 2007; 21 (04) 338-343
  • 58 May M. , Conley Factors in selecting surgical technique. In: May M, Schaitkin BM. Facial Paralysis: Rehabilitation Techniques. Georg Thieme Verlag KG, Stuttgart. 2003: 6-10
  • 59 Leong SC, Lesser TH, Andrews P, Saeed SR. Transoral orthodromic temporalis muscle transfer technique for dynamic reanimation of the paralysed face. Clin Otolaryngol 2016; 41 (06) 831-833
  • 60 Andrews P, Randhawa PS, Joseph J. et al. A prospective 4-year study of the objective and subjective outcomes of fifteen patients after dynamic facial reanimation surgery. Clin Otolaryngol 2016; 41 (06) 825-829
  • 61 Saeed SR, Ramsden RT. Rehabilitation of the paralysed face: results of facial nerve surgery. J Laryngol Otol 1996; 110 (10) 922-925
  • 62 Owusu JA, Boahene KD. Management of long-standing flaccid facial palsy: midface/smile: locoregional muscle transfer. Otolaryngol Clin North Am 2018; 51 (06) 1119-1128
  • 63 Oyer SL, Nellis J, Ishii LE, Boahene KD, Byrne PJ. Comparison of objective outcomes in dynamic lower facial reanimation with temporalis tendon and gracilis free muscle transfer. JAMA Otolaryngol Head Neck Surg 2018; 144 (12) 1162-1168
  • 64 Oh TS, Kim HB, Choi JW, Jeong WS. Facial reanimation with masseter nerve-innervated free gracilis muscle transfer in established facial palsy patients. Arch Plast Surg 2019; 46 (02) 122-128
  • 65 Watanabe Y, Yamamoto T, Hirai R, Sasaki R, Agawa K, Akizuki T. One-stage free transfer of latissimus dorsi-serratus anterior combined muscle flap with dual innervation for smile reanimation in established facial paralysis. J Plast Reconstr Aesthet Surg 2020; 73 (06) 1107-1115
  • 66 Park JH, Park SO, Chang H. Facial reanimation using free partial latissimus dorsi muscle transfer: single versus dual innervation method. J Craniomaxillofac Surg 2022; 50 (10) 778-784
  • 67 Deramo PJ, Seitz AJ, Shakir S. et al. Dual-innervated free gracilis muscle transfer for facial reanimation in children. Ann Plast Surg 2022; 89 (05) 538-542
  • 68 Natghian H, Fransén J, Rozen SM, Rodriguez-Lorenzo A. Qualitative and quantitative analysis of smile excursion in facial reanimation: a systematic review and meta-analysis of 1- versus 2-stage procedures. Plast Reconstr Surg Glob Open 2017; 5 (12) e1621