Frequency and Clinical Outcomes of Facial Nerve Palsy at District Level Teaching Hospital, Pakistan
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Abstract
Background: Facial nerve palsy, characterized by the dysfunction of the seventh cranial nerve, is a common neurological disorder that significantly impacts patients' quality of life. It manifests as unilateral facial weakness or paralysis, with Bell's palsy being the most prevalent cause. This condition requires thorough clinical evaluation and appropriate management to ensure optimal recovery outcomes.
Objective: The objective of this study was to determine the frequency and clinical outcomes of facial nerve palsy in patients presenting to a district-level teaching hospital in Lakki Marwat, Pakistan.
Methods: A cross-sectional study was conducted from May 2023 to October 2023 at the Physiotherapy Department of District Headquarter Hospital, Lakki Marwat. Patients with a confirmed diagnosis of facial nerve palsy by a neurophysician were included, while those with congenital facial nerve palsy or upper motor neuron lesions were excluded. Ethical approval was obtained, and written informed consent was collected from all participants. Clinical assessments were performed using the House-Brackmann scale to evaluate the severity of facial nerve dysfunction. Data were collected through a semi-structured questionnaire and analyzed using SPSS version 25. Descriptive statistics, including frequencies, percentages, means, and standard deviations, were used to present the data.
Results: Out of 102 patients, 59 (57.9%) were male, and 43 (42.1%) were female, with a mean age of 38.2 ± 10.36 years. The majority of patients (41.1%) were in the 31-40 years age group. Right-side facial palsy was more prevalent, affecting 64 (62.7%) patients. The House-Brackmann grading revealed that 49 (48.2%) patients were in Grade IV, 24 (23.5%) in Grade V, 15 (14.7%) in Grade III, 8 (7.8%) in Grade VI, and 6 (5.8%) in Grade II. Bell’s palsy was the most common cause, accounting for 52 (51%) cases, followed by external trauma in 22 (21.6%) patients, infections in 18 (17.6%) patients, and tumors in 10 (9.8%) patients. Treatment outcomes showed complete recovery in 65 (63.7%) patients, incomplete recovery in 28 (27.5%), and no recovery in 9 (8.8%).
Conclusion: Facial nerve palsy was more common in male patients, with the right side of the face being predominantly affected. Bell’s palsy was identified as the leading cause. The study highlights the importance of early diagnosis and intervention, particularly physiotherapy, in managing facial nerve palsy. Further research is recommended to explore long-term outcomes and optimize treatment strategies.
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References
Kochhar A, Larian B, Azizzadeh B. Facial Nerve and Parotid Gland Anatomy. Otolaryngol Clin North Am. 2016;49(2):273-84.
Chhabda S, St Leger D, Lingam RK. Imaging the Facial Nerve: A Contemporary Review of Anatomy and Pathology. Eur J Radiol. 2020;126:108920.
Gupta S, Mends F, Hagiwara M, Fatterpekar G, Roehm PC. Imaging the Facial Nerve: A Contemporary Review. Radiol Res Pract. 2013;2013.
Zimmermann J, Jesse S, Kassubek J, Pinkhardt E, Ludolph AC. Differential Diagnosis of Peripheral Facial Nerve Palsy: A Retrospective Clinical, MRI and CSF-Based Study. J Neurol. 2019;266:2488-94.
Schimmel M, Ono T, Lam O, Müller F. Oro‐Facial Impairment in Stroke Patients. J Oral Rehabil. 2017;44(4):313-26.
Plumbaum K, Volk G, Boeger D, Buentzel J, Esser D, Steinbrecher A, et al. Inpatient Treatment of Patients with Acute Idiopathic Peripheral Facial Palsy: A Population‐Based Healthcare Research Study. Clin Otolaryngol. 2017;42(6):1267-74.
Klassen AF, Rae C, Gallo L, Norris JH, Bogart K, Johnson D, et al. Psychometric Validation of the FACE-Q Craniofacial Module for Facial Nerve Paralysis. Facial Plast Surg Aesthet Med. 2022;24(1):1-7.
Hotton M, Huggons E, Hamlet C, Shore D, Johnson D, Norris JH, et al. The Psychosocial Impact of Facial Palsy: A Systematic Review. Br J Health Psychol. 2020;25(3):695-727.
Jain V, Deshmukh A, Gollomp S. Bilateral Facial Paralysis: Case Presentation and Discussion of Differential Diagnosis. J Gen Intern Med. 2006;21.
Phan NT, Panizza B, Wallwork B. A General Practice Approach to Bell's Palsy. Aust Fam Physician. 2016;45(11):794-7.
Shokri T, Saadi R, Schaefer EW, Lighthall JG. Trends in the Treatment of Bell's Palsy. Facial Plast Surg. 2020;36(05):628-34.
John Delphine A, Samuel VM, Gaikwad P, Sharma SL, Thomas CT. Inter-and Intra-Rater Reliability of Modified House-Brackmann and Sunnybrook Facial Nerve Grading Systems in Post Parotidectomy Patients. Indian J Otolaryngol Head Neck Surg. 2023;75(1):100-8.
Alshami S, Hodge D, Bradley E. The Epidemiology and Surgical Outcomes of Facial Nerve Palsy in a Population-Based Cohort. Invest Ophthalmol Vis Sci. 2017;58(8):3848-.
Hohman MH, Hadlock TA. Etiology, Diagnosis, and Management of Facial Palsy: 2000 Patients at a Facial Nerve Center. Laryngoscope. 2014;124(7).
Chweya CM, Anzalone CL, Driscoll CL, Lane JI, Carlson ML. For Whom the Bell's Toll: Recurrent Facial Nerve Paralysis, a Retrospective Study and Systematic Review of the Literature. Otol Neurotol. 2019;40(4):517-28.
Psillas G, Antoniades E, Ieridou F, Constantinidis J. Facial Nerve Palsy in Children: A Retrospective Study of 124 Cases. J Paediatr Child Health. 2019;55(3):299-304.
Papan C, Kremp L, Weiß C, Petzold A, Schroten H, Tenenbaum T. Infectious Causes of Peripheral Facial Nerve Palsy in Children—A Retrospective Cohort Study with Long-Term Follow-Up. Eur J Clin Microbiol Infect Dis. 2019;38:2177-84.
Chang Y-S, Choi JE, Kim SW, Baek S-Y, Cho Y-S. Prevalence and Associated Factors of Facial Palsy and Lifestyle Characteristics: Data from the Korean National Health and Nutrition Examination Survey 2010–2012. BMJ Open. 2016;6(11).
Zonnour A, Shahnazar R, Jamshidi A, Dabiri S, Saedi E, Emami H, et al. Cranial Nerve Palsy Prevalence and Associated Factors in Patients with Malignant Otitis Externa. Laryngoscope Investig Otolaryngol. 2023;8(2):538-45.
Gatidou AM, Kottaras A, Lytras D, Gatidou C, Iakovidis P, Kottaras I. Physiotherapy Management of Bell’s Palsy-A Review of Evidenced Based Physiotherapy Practice. Int J Adv Med. 2021;3(1):402-6.
Vaughan A, Gardner D, Miles A, Copley A, Wenke R, Coulson S. A Systematic Review of Physical Rehabilitation of Facial Palsy. Front Neurol. 2020;11:222.