Impact of Facial Paralysis on Patients With Acoustic Neuroma

Abstract

Objective: To assess the psychological distress, the ways of coping with that stress, and the selfesteem of patients with facial paralysis after acoustic neuroma surgery. Possible predictors and associations between these measures were also explored. Study Design: Four validated questionnaires were completed by patients with facial paralysis after acoustic neuroma surgery: 1) the Derriford Appearance Scale (DAS) to measure psychological distress, 2) the COPE questionnaire to measure how patients cope with facial paralysis, 3) the Personal Report questionnaire to measure the self-esteem of patients, and 4) the Facial Paralysis Questionnaire (FPQ) to measure the severity of facial paralysis. Patients: One hundred three patients with facial paralysis after surgical removal of acoustic tumors. Results: Distress spanned a wide range in these patients. There was no statistically significant association between the level of distress and the grade of facial paralysis or between time since operation and levels of distress. Women had higher levels of distress (P ‫؍‬ .02) and a significant negative correlation was found between levels of distress and age (r ‫؍‬ ؊0.28, P ‫؍‬ .005). High levels of distress were associated with low levels of self-esteem, as shown by the significant negative correlation between level of distress and self-esteem (r ‫؍‬ ؊0.59, P ‫؍‬ .01). A significant correlation between distress and maladaptive coping (r ‫؍‬ 0.31, P ‫؍‬ .002) was also found. Stepwise multiple regression of the distress scores revealed that self-esteem was the most important contributing factor (standardized coefficient ␤ ؊0.60, P ‫؍‬ .0001), followed by age (␤ ؊0.24, P ‫؍‬ .006) and sex (␤ ؊0.21, P ‫؍‬ .04). This model explained 44% of the distress variance. Conclusion: Clinicians must be aware of the distress felt by some patients experiencing facial palsy after acoustic neuroma surgery and that the level of distress may not be related to the clinical grade of the facial nerve paralysis. People with low self-esteem, young people, and women suffer from more distress due to the facial palsy. Clinicians should thoroughly counsel patients before and after surgery and should implement measures that increase patients' self-esteem and decrease their distress, especially in these high-risk groups.

Long-term facial nerve clinical evaluation following vestibular schwannoma surgery

“…loss of facial nerve function is a debilitating and psychologically devastating condition 13 . Patients with FP may experience several limitations as difficulty to speech and eat and may experience drooling.…”

Classic Hypoglossal-Facial Nerve Anastomosis after Acoustic Neuroma Resection

“…The questionnaire was returned by all patients either at the time of the interview or later by mail. Although a number of excellent questionnaires for facial nerve paralysis have been reported [21][22][23], we designed the questionnaire ourselves to more specifically clarify the problems related to hypoglossalfacial nerve anastomosis (Appendix). Statistical analyses were made using either the Spearman's rank correlation test or the Mann-Whitney U test.…”

Psychological distress in people with disfigurement from facial palsy

“…4,5 Facial palsy is a form of facial disfigurement and patients can experience severe psychological and social problems. 6 Their facial expression is either diminished or altered, affecting normal face-to-face communication with others, and non-verbal facial signs can be misinterpreted. 7 Functional problems such as eating and drinking can cause embarrassment.…”