Assessing psychological distress in patients with facial paralysis using the Hospital Anxiety and Depression Scale

Pouwels, Sjaak; Beurskens, Carien H. G.; Kleiss, Ingrid J.; Ingels, K.J.A.O.

doi:10.1016/j.bjps.2016.01.021

Cited by 40 publications

(26 citation statements)

References 26 publications

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“…Given methodological differences, it is difficult to directly compare our findings with other studies but the prevalence of anxiety and depression found in this study is slightly less than those reported for facial palsy (Fu et al, 2011) and facial paralysis (Pouwels et al, 2016). The findings suggest that facial scarring may result in a similar burden of depression but lower burden of anxiety than seen in acne patients (Lukaviciute et al, 2017), and a lower burden of depression compared to orthopaedic trauma patients (Muscatelli et al, 2016 (Egede, 2007).…”

Section: Biascontrasting

confidence: 78%

The association of affective disorders and facial scarring: Systematic review and meta-analysis

Gibson

Ackling

Bisson

et al. 2018

Journal of Affective Disorders

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Section: Biascontrasting

confidence: 78%

The association of affective disorders and facial scarring: Systematic review and meta-analysis

Gibson

Ackling

Bisson

et al. 2018

Journal of Affective Disorders

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“…In a retrospective study, Walker et al 32 found that 40% of patients with facial paralysis showed symptoms suggestive of an anxiety or depressive mood disorder. Moreover, Pouwels et al 33 showed that 27% of patients with facial paralysis, either before or after surgery, were identified as having a depressive disorder. Similarly, we found that a significant proportion of the patients with facial paralysis screened positive for depression at initial evaluation compared with control patients.…”

Section: Discussionmentioning

confidence: 99%

Association Among Facial Paralysis, Depression, and Quality of Life in Facial Plastic Surgery Patients

Nellis

Ishii

Byrne

et al. 2017

JAMA Facial Plast Surg

157

127

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IMPORTANCE Though anecdotally linked, few studies have investigated the impact of facial paralysis on depression and quality of life (QOL).OBJECTIVE To measure the association between depression, QOL, and facial paralysis in patients seeking treatment at a facial plastic surgery clinic.DESIGN, SETTING, PARTICIPANTS Data were prospectively collected for patients with all-cause facial paralysis and control patients initially presenting to a facial plastic surgery clinic from 2013 to 2015. The control group included a heterogeneous patient population presenting to facial plastic surgery clinic for evaluation. Patients who had prior facial reanimation surgery or missing demographic and psychometric data were excluded from analysis.MAIN OUTCOMES AND MEASURES Demographics, facial paralysis etiology, facial paralysis severity (graded on the House-Brackmann scale), Beck depression inventory, and QOL scores in both groups were examined. Potential confounders, including self-reported attractiveness and mood, were collected and analyzed. Self-reported scores were measured using a 0 to 100 visual analog scale. RESULTSThere was a total of 263 patients (mean age, 48.8 years; 66.9% were female) were analyzed. There were 175 control patients and 88 patients with facial paralysis. Sex distributions were not significantly different between the facial paralysis and control groups. Patients with facial paralysis had significantly higher depression, lower self-reported attractiveness, lower mood, and lower QOL scores. Overall, 37 patients with facial paralysis (42.1%) screened positive for depression, with the greatest likelihood in patients with House-Brackmann grade 3 or greater (odds ratio, 10.8; 95% CI, 5.13-22.75) compared with 13 control patients (8.1%) (P < .001). In multivariate regression, facial paralysis and female sex were significantly associated with higher depression scores (constant, 2.08 [95% CI, 0.77-3.39]; facial paralysis effect, 5. 98 [95% CI,]; female effect, 1.95 [95% CI, 0.65-3.25]). Facial paralysis was associated with lower QOL scores (constant, 81.62 [95% CI,]; facial paralysis effect, −16.06 [95% CI,).CONCLUSIONS AND RELEVANCE For treatment-seeking patients, facial paralysis was significantly associated with increased depression and worse QOL scores. In addition, female sex was significantly associated with increased depression scores. Moreover, patients with a greater severity of facial paralysis were more likely to screen positive for depression. Clinicians initially evaluating patients should consider the psychological impact of facial paralysis to optimize care.LEVEL OF EVIDENCE 2.

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“…In addition to physical detriments, subsequent psychosocial stress, and depression are well documented. [1][2][3][4][5][6] In many cases, medical treatment is insufficient and surgical correction is sought.…”

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confidence: 99%

Masseteric Nerve Transfer for Facial Nerve Paralysis

Murphey

Clinkscales

Oyer

2018

JAMA Facial Plast Surg

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IMPORTANCE A review of the role of masseteric nerve transfer is needed to guide its use in facial reanimation. OBJECTIVE To systematically review the available literature, and, when applicable, analyze the combined outcomes of masseteric nerve transfer to better define its role in reanimation and to guide further research. DATA SOURCES Two independent researchers conducted the review using PubMed-NCBI and Scopus literature databases for studies on masseteric nerve transfer for facial nerve paralysis. STUDY SELECTION Studies that examined masseter nerve transfer with additional cranial nerve transposition/coaptation or muscle flap were excluded. DATA EXTRACTION AND SYNTHESIS Literature review and data extraction followed established PRISMA guidelines. Two researchers extracted data independently. MAIN OUTCOMES AND MEASURES The main planned outcomes for the study were quantitative results of facial nerve movement after nerve transfer including oral commissure movement and time to nerve recovery. RESULTS A total of 13 articles met inclusion criteria with a total of 183 patients undergoing masseteric nerve transfer. From those studies, there were a total of 183 patients who underwent masseteric nerve transfer. There were 85 men and 98 women with a mean (SD) age of 43 (12.2) years and mean (SD) follow up examination after surgery of 22 (7.6) months. Mean (SD) duration of nerve paralysis was 14 (6) months. Most common cause of paralysis was cerebellopontine angle tumors (81%). Six studies coapted the masseteric nerve to the main facial nerve trunk, whereas 7 used distal branches (buccal or zygomatic). Four studies used interposition nerve grafts with great auricular nerve. Two measures, improvement in oral commissure excursion and length from reanimation to facial movement, were measured consistently across the studies. Pooled analysis showed time from surgery to first facial movement, described in 10 studies, to be 4.95 months (95% CI, 3.66 to 6.24). Distal branch coaptation improved time to recovery vs main branch coaptation, 3.76 vs 5.76 months (95% CI, −0.33 to 4.32), but mean difference was not significant. The use of interposition graft significantly delayed time of nerve recovery, 6.24 vs 4.06 months (95% CI, 0.20 to 4.16). When controlled for main trunk coaptation only, interposition nerve graft delayed recovery but difference was no longer statistically significant, 6.24 vs 4.75 months (95% CI, −0.94 to 3.92). Reported complications were minor and rare occurring in only 6.5% (12 of 183) of patients. CONCLUSIONS AND RELEVANCE The masseteric nerve was found to be a good option for nerve transfer in this patient population, and showed favorable results in both time to nerve recovery and improvement in oral commissure excursion. LEVEL OF EVIDENCE NA.

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Assessing psychological distress in patients with facial paralysis using the Hospital Anxiety and Depression Scale

Cited by 40 publications

References 26 publications

The association of affective disorders and facial scarring: Systematic review and meta-analysis

The association of affective disorders and facial scarring: Systematic review and meta-analysis

Association Among Facial Paralysis, Depression, and Quality of Life in Facial Plastic Surgery Patients

Masseteric Nerve Transfer for Facial Nerve Paralysis

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