Analysis of Predictive Factors for the Poor Prognosis of Peripheral Facial Paralysis

Am J Phys Med Rehabil. 2024 Mar 1;103(3):245-250. doi: 10.1097/PHM.0000000000002328. Epub 2023 Aug 21.

Abstract

Purpose: The aim of the study is to evaluate the predictive factors for a poor prognosis in patients with facial paralysis evaluated in the rehabilitation department of a tertiary hospital.

Methods: We have conducted a prospective cohort study. Patients who required elective botulinum toxin infiltration, surgical treatment, or follow-up appointments longer than 6 months due to incomplete recovery were considered to have a poor prognosis. Descriptive and analytical analyses of clinical and epidemiological variables were performed. The follow-up period was 6 mos.

Results: A total of 47 adult patients were analyzed, 54.2% of whom were women. The mean age was 53.2 yrs (SD, 15.5 yrs). Twenty-five percent had an unfavorable prognosis. A statistically significant association with prognosis was observed for neurophysiological results and the scores of the House-Brackmann scale and the Sunnybrook Facial Grading System.

Conclusions: Neurophysiological tests are especially useful when evaluating prognosis. Likewise, Sunnybrook Facial Grading System is a useful and accessible tool with prognostic value, especially within a month of initial diagnosis, when a score lower than 65 indicates a poor prognosis with high sensitivity and specificity. These tools can be especially useful to reduce the clinical and psychological impact and to provide patients with early therapeutic management.

MeSH terms

  • Adult
  • Facial Paralysis* / etiology
  • Facial Paralysis* / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies