Multidisciplinary Care of Patients with Facial Palsy: Treatment of 1220 Patients in a German Facial Nerve Center
Abstract
:1. Introduction
2. Material and Methods
2.1. Ethical Considerations
2.2. Study Design and Inclusion Criteria
2.3. Diagnostics and Assessment of Initial and Final Facial Nerve Function
2.4. Treatment
2.5. Statistics
3. Results
3.1. Baseline and Facial Palsy Characteristics
3.2. Diagnostics
3.3. Treatment
3.4. Facial Nerve Function at Initial and Last Visits
3.5. Outcome
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Statement of Financial Interest
References
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Acute Palsy n = 697 | Chronic Palsy n = 523 | |||
---|---|---|---|---|
Parameter | Absolute (N) | Absolute (N) | Χ2, df | p* |
Gender | ||||
Female | 365 | 348 | 24.7, 1 | <0.0001 |
Male | 332 | 175 | ||
Side | 7.7, 2 | 0.021 | ||
Right | 343 | 224 | ||
Left | 352 | 293 | ||
Bilateral | 2 | 6 | ||
Recurrent palsy | 4.5, 1 | 0.039 | ||
No | 646 | 500 | ||
Yes | 51 | 23 | ||
Localization | 1.4, 2 | 0.490 | ||
peripheral | 692 | 519 | ||
central | 5 | 3 | ||
nuclear | 0 | 1 | ||
Etiology | 69.3, 6 | <0.0001 | ||
idiopathic | 306 | 207 | ||
Iatrogenic ** | 197 | 139 | ||
infectious/inflammatory | 104 | 94 | ||
traumatic | 19 | 24 | ||
neoplastic, benign | 11 | 31 | ||
neoplastic, malignant | 0 | 3 | ||
congenital | 0 | 25 | ||
Mean ± SD | Mean ± SD | T, df | p | |
Age (years) at initial diagnosis | 53.0 ± 18.6 | 41.2 ± 20.3 | 10.6, 1218 | <0.0001 |
Age (years) at initial presentation | 53.0 ± 18.6 | 46.4 ± 18.2 | 6.2, 1218 | <0.0001 |
Interval (years) onset to initial presentation | 0.02 ± 0.04 | 5.3 ± 9.2 | −15.3, 1218 | <0.0001 |
Acute Palsy n = 697 | Chronic Palsy n = 523 | |||
---|---|---|---|---|
Parameter | Absolute (N) | Absolute (N) | Χ2, df | p* |
Sonography of the neck | 364.2, 1 | <0.0001 | ||
Yes | 451 | 54 | ||
No | 246 | 469 | ||
Sonography of the facial muscles | 51.5, 1 | <0.0001 | ||
Yes | 65 | 128 | ||
No | 632 | 395 | ||
Magnet resonance imaging, cranial | 38.2, 1 | <0.0001 | ||
Yes | 112 | 25 | ||
No | 585 | 498 | ||
Computed tomography, cranial | 44.2, 1 | <0.0001 | ||
Yes | 80 | 8 | ||
No | 617 | 515 | ||
Facial electrophysiology | 5.1, 1 | 0.024 | ||
Yes | 596 | 470 | ||
No | 101 | 53 | ||
Facial photo series | 31.6, 1 | <0.0001 | ||
Yes | 613 | 503 | ||
No | 79 | 14 | ||
Audiometry | 10.9, 1 | 0.001 | ||
Yes | 508 | 335 | ||
No | 189 | 188 | ||
Tympanometry | 18.3, 1 | <0.0001 | ||
Yes | 496 | 311 | ||
No | 201 | 212 | ||
Stapedius reflex test | 14.3, 1 | <0.0001 | ||
Yes | 482 | 307 | ||
No | 215 | 216 | ||
Gustatory test | 47.3, 1 | <0.0001 | ||
Yes | 477 | 256 | ||
No | 220 | 267 | ||
Vestibular tests | 101.9, 1 | <0.0001 | ||
Yes | 484 | 212 | ||
No | 213 | 311 | ||
Schirmer test | 47.1, 1 | <0.0001 | ||
Yes | 488 | 233 | ||
No | 249 | 290 | ||
Serology | 454.5, 1 | <0.0001 | ||
Yes | 429 | 12 | ||
No | 268 | 511 |
Acute Palsy n = 697 | Chronic Palsy n = 523 | |||
---|---|---|---|---|
Parameter | Absolute (N) | Absolute (N) | Χ2, df | p* |
Glucocorticoids | 760.0, 1 | <0.0001 | ||
Yes | 564 | 7 | ||
No | 133 | 516 | ||
Acyclovir | 413.5, 1 | <0.0001 | ||
Yes | 384 | 2 | ||
No | 313 | 521 | ||
Antibiotics | 39.9, 1 | <0.0001 | ||
Yes | 60 | 3 | ||
No | 637 | 520 | ||
Facial nerve reconstruction | ||||
Facial nerve reconstruction, any | 16 | 33 | 14.7, 1 | 0.001 |
Facial-facial nerve suture | 2 | 2 | 0.01, 1 | 1.000 |
Facial nerve interpositional graft | 6 | 2 | 1.1, 1 | 0.478 |
Hypoglossal–facial-nerve jump suture | 10 | 31 | 18.6, 1 | <0.0001 |
Muscle and sling plasty | ||||
Temporal muscle transfer | 0 | 1 | 1.3, 1 | 0.429 |
Sling plasty angle of the mouth | 4 | 12 | 6–8, 1 | 0.011 |
Eyelid surgery | ||||
Upper eyelid weight | 31 | 46 | 9.6, 1 | 0.003 |
Tarsorrhaphy | 1 | 9 | 13.2, 1 | 0.001 |
Kanthopexy | 3 | 9 | 8.4, 1 | 0.006 |
Brow plasty | 7 | 15 | 10.8, 1 | 0.002 |
Blepharoplasty | 2 | 13 | 17.5, 1 | 0.001 |
Lower lid plasty | 8 | 17 | 12.1, 1 | 0.013 |
Non-surgical adjuvant therapy | ||||
Physical therapy/speech therapy | 55 | 47 | 0.5, 1 | 0.531 |
Electrotherapy | 11 | 47 | 51.5, 1 | <0.0001 |
Botulinumtoxin injection | 41 | 132 | 92.0, 1 | <0.0001 |
Eye moisture chamber | 423 | 12 | 444.1, 1 | <0.0001 |
Eye drops/ointment | 430 | 20 | 430.0, 1 | <0.0001 |
Facial exercises at home | 441 | 14 | 469.1, 1 | <0.0001 |
Facial EMG biofeedback training | 31 | 255 | 326.9, 1 | <0.0001 |
Parameter | SI, Total (Mean ± SD) | FDI, Physical (Mean ± SD) | FDI, Social (Mean ± SD) | FDI, Total (Mean ± SD) | FaCE, Total (Mean ± SD) | SF-36, PFI (Mean ± SD) | SF-36, GHP (Mean ± SD) |
---|---|---|---|---|---|---|---|
Gender | |||||||
Female | 4.5 ± 3.0 | 64.2 ± 20.4 | 66.2 ± 21.1 | 65.1 ± 18.0 | 57.3 ± 22.8 | 80.3 ± 26.4 | 57.5 ± 21.0 |
Male | 5.1 ± 3.0 | 69.7 ± 20.1 | 74.5 ± 20.4 | 72.0 ± 17.2 | 67.7 ± 21.7 | 85.0 ± 21.6 | 62.8 ± 20.8 |
T, df | −3.6, 1218 | −4.0, 846 | −5.9, 841 | −5.9, 847 | −6.4, 829 | −2.8, 811 | −3.5, 796 |
p * | <0.0001 | <0.0001 | <0.0001 | <0.0001 | <0.0001 | 0.005 | <0.0001 |
Age at first presentation | |||||||
< median 50 years | 4.4 ± 2.9 | 69.6 ± 20.0 | 70.5 ± 20.6 | 70.0 ± 17.9 | 62.7 ± 22.1 | 88.9 ± 20.3 | 61.4 ± 21.4 |
≥ median 50 years | 5.0 ± 3.1 | 63.1 ± 20.4 | 68.5 ± 20.9 | 65.5 ± 17.9 | 60.8 ± 23.9 | 72.6 ± 25.4 | 58.2 ± 19.9 |
T, df | −3.6, 1218 | 4.7, 846 | 1.8, 841 | 3.7, 847 | 1.6, 829 | 8.5, 811 | 4.4, 796 |
p * | <0.0001 | <0.0001 | 0.065 | <0.0001 | 0.118 | <0.0001 | <0.0001 |
Interval onset to first presentation | |||||||
≤90 days (acute facial palsy) | 5.1 ± 2.9 | 69.6 ± 21.1 | 75.9 ± 18.1 | 72.6 ± 17.3 | 72.3 ± 23.2 | 80.2 ± 24.3 | 59.8 ± 20.1 |
>90 days (chronic facial palsy) | 4.2 ± 3.1 | 63.7 ± 19.5 | 64.2 ± 21.2 | 63.9 ± 17.6 | 53.8 ± 19.2 | 80.8 ± 24.7 | 58.8 ± 22.2 |
T, df | 5.3, 1218 | 4.0, 846 | 8.0, 841 | 7.0, 847 | 12.5, 829 | −1.1, 811 | 2.3, 796 |
p * | <0.0001 | <0.0001 | <0.0001 | <0.0001 | <0.0001 | 0.253 | 0.023 |
Etiology | |||||||
idiopathic | 4.7 ± 2.8 | 68.7 ± 20.8 | 70.4 ± 21.3 | 69.3 ± 18.4 | 65.5 ± 22.8 | 83.2 ± 22.7 | 59.8 ± 20.9 |
iatrogenic | 4.4 ± 3.1 | 64.6 ± 18.3 | 70.2 ± 19.9 | 67.4 ± 16.5 | 59.4 ± 21.5 | 78.4 ± 24.5 | 61.7 ± 20.2 |
infectious/inflammatory | 4.8 ± 2.9 | 60.3 ± 21.4 | 64.7 ± 20.2 | 62.6 ± 18.8 | 57.3 ± 25.2 | 74.4 ± 28.1 | 55.3 ± 23.7 |
traumatic | 4.6 ± 3.2 | 72.1 ± 21.8 | 70.0 ± 20.9 | 70.8 ± 17.5 | 60.8 ± 22.4 | 76.4 ± 31.6 | 54.9 ± 18.5 |
neoplastic, benign | 7.9 ± 2.4 | 62.7 ± 14.7 | 64.8 ± 16.7 | 63.8 ± 12.4 | 47.2 ± 12.5 | 83.5 ± 17.4 | 56.5 ± 17.2 |
neoplastic, malignant | 8.3 ± 1.2 | 60.0 ± 0 | 82.0 ± 8.5 | 71.0 ± 4.2 | 45.8 ± 20.0 | 90.0 ± 14.4 | 61.0 ± 1.4 |
congenital | 4.9 ± 2.7 | 87.5 ± 13.2 | 86.8 ± 13.7 | 87.1 ± 11.2 | 72.8 ± 16.2 | 100.0 ± 0 | 75.8 ± 24.6 |
F, df | 9.5, 6 | 7.0, 6 | 3.4, 6 | 6.6, 6 | 6.5, 6 | 4.2, 6 | 3.8, 6 |
p * | <0.0001 | 0.003 | 0.001 | <0.0001 | <0.0001 | <0.0001 | 0.001 |
Parameter | SI, Total (Mean ± SD) | FDI, Physical (Mean ± SD) | FDI, Social (Mean ± SD) | FDI, Total (Mean ± SD) | FaCE, Total (Mean ± SD) | SF-36, PFI (Mean ± SD) | SF-36, GHP (Mean ± SD) |
---|---|---|---|---|---|---|---|
Gender | |||||||
Female | 2.0 ± 2.5 | 74.7 ± 17.4 | 74.7 ± 17.0 | 74.7 ± 15.2 | 64.7 ± 20.1 | 83.4 ± 22.6 | 63.3 ± 21.2 |
Male | 2.2 ± 2.9 | 78.0 ± 17.6 | 79.0 ± 17.8 | 84.4 ± 26.5 | 73.2 ± 19.7 | 82.1 ± 25.7 | 61.6 ± 20.4 |
T, df | −0.6, 1072 | −1.6, 621 | −2.6, 617 | −2.5, 617 | −4.0, 618 | −0.2, 618 | −0.1, 618 |
p * | 0.519 | 0.105 | 0.011 | 0.014 | <0.0001 | 0.781 | 0.679 |
Age at first presentation | |||||||
< median 50 years | 2.3 ± 2.7 | 79.3 ± 16.3 | 76.7 ± 17.2 | 78.1 ± 15.1 | 69.1 ± 19.4 | 90.8 ± 17.6 | 65.5 ± 21.2 |
> median 50 years | 1.9 ± 2.7 | 71.8 ± 18.0 | 75.5 ± 17.6 | 73.7 ± 56.8 | 65.9 ± 21.2 | 74.9 ± 26.4 | 59.6 ± 20.2 |
T, df | 2.5, 1072 | 4.4, 621 | 0.6, 617 | 2.6, 617 | 1.1, 618 | 6.4, 618 | 3.7, 618 |
p * | 0.012 | <0.0001 | 0.499 | 0.009 | 0.295 | <0.0001 | <0.0001 |
Interval onset to first presentation | |||||||
≤90 days (acute facial palsy) | 1.2 ± 2.3 | 80.1 ± 18.1 | 80.1 ± 16.1 | 85.4 ± 23.1 | 77.6 ± 21.1 | 84.0 ± 22.6 | 64.2 ± 25.7 |
>90 days (chronic facial palsy) | 3.6 ± 2.7 | 73.3 ± 16.7 | 73.8 ± 17.7 | 73.6 ± 15.2 | 62.7 ± 17.9 | 81.1 ± 25.7 | 60.2 ± 19.5 |
T, df | −15.2, 1072 | 3.8, 621 | 2.4, 617 | 3.6, 617 | 8.2, 618 | −0.7, 618 | 0.2, 618 |
p * | <0.0001 | <0.0001 | 0.017 | <0.0001 | <0.0001 | 0.533 | 0.812 |
Etiology | |||||||
idiopathic | 1.4 ± 2.0 | 77.6 ± 17.4 | 77.9 ± 16.4 | 77.8 ± 14.7 | 72.9 ± 18.6 | 86.3 ± 21.6 | 66.7 ± 22.4 |
iatrogenic | 2.5 ± 2.9 | 75.1 ± 17.4 | 76.2 ± 16.9 | 82.4 ± 17.3 | 62.7 ± 20.9 | 83.2 ± 19.9 | 58.2 ± 14.9 |
infectious/inflammatory | 2.0 ± 2.3 | 74.0 ± 16.8 | 73.7 ± 19.7 | 77.9 ± 14.4 | 65.9 ± 20.1 | 70.5 ± 14.0 | 54.8 ± 24.6 |
traumatic | 3.0 ± 3.2 | 82.2 ± 18.1 | 77.5 ± 13.5 | 79.8 ± 13.6 | 73.3 ± 17.9 | 92.0 ± 17.9 | 77.0 ± 15.4 |
neoplastic, benign | 7.4 ± 2.0 | 60.9 ± 14.8 | 65.2 ± 18.3 | 63.0 ± 14.3 | 49.5 ± 17.6 | 84.2 ± 22.2 | 65.8 ± 15.0 |
neoplastic, malignant | 10 ± 0 | 75.0 ± 0 | 80.0 ± 0 | 77.5 ± 0 | 48.3 ± 0 | NA | NA |
congenital | 4.2 ± 2.8 | 96.3 ± 2.5 | 92.8 ± 3.6 | 94.5 ± 2.0 | 83.3 ± 4.1 | 95.0 ± 0 | 62.0 ± 0 |
F, df | 42.4, 6 | 3.3, 6 | 1.7, 6 | 3.0, 6 | 5.1, 6 | 2.0, 6 | 2.8, 6 |
p * | <0.0001 | 0.003 | 0.108 | 0.008 | <0.0001 | 0.066 | 0.010 |
Stennert Index, Sum | Facial Disability Index, Total | |||||||
---|---|---|---|---|---|---|---|---|
First Visit Mean ± SD | Last Visit Mean ± SD | T, df | p | First Visit Mean ± SD | Last Visit Mean ± SD | T, df | p ** | |
All | 4.8 ± 3.0 | 2.1 ± 2.7 | 28.8, 1073 | <0.0001 | 64.8 ± 16.6 | 76.0 ± 16.7 | −14.7, 604 | <0.0001 |
Glucocorticoids | 5.1 ± 2.7 | 1.1 ± 2.1 | 32.1, 570 | <0.0001 | 68.3 ± 6.9 | 87.4 ± 70.1 | −82, 327 | 0.006 |
Acyclovir | 5.6 ± 2.5 | 1.0 ± 2.0 | 32.1, 384 | <0.0001 | 68.7 ± 16.4 | 81.0 ± 15.0 | −5.2, 170 | <0.001 |
Glucocorticoids± Acyclovir | 5.7 ± 2.5 | 1.0 ± 2.0 | 32.8, 380 | <0.0001 | 62.5 ± 19.4 | 80.5 ± 17.6 | −6.0, 180 | <0.0001 |
Antibiotics | 5.6 ± 2.7 | 1.8 ± 2.9 | 10.0, 62 | <0.0001 | 65.9 ± 12.6 | 78.9 ± 27.4 | −3.8, 18 | 0.021 |
Facial nerve reconstruction, any | 8.6 ± 1.7 | 6.8 ± 2.6 | 5.1, 48 | <0.0001 | 67.3 ± 16.7 | 71.3 ± 19.9 | −2.4, 32 | 0.019 |
Facial–facial nerve suture | NA | NA | NA | NA | 74.25 ± 7.4 | 72.7.5 ± 8.7 | 3.0, 1 | 0.205 |
Facial nerve interpositional graft | 8.3 ± 1.5 | 5.9 ± 3.0 | 2.1, 7 | 0.074 | 73.5 ± 7.4 | 73.5 ± 8.7 | 0, 3 | 1.000 |
Hypoglossal–facial-nerve jump suture | 8.7 ± 1.3 | 6.8 ± 2.5 | 4.9, 40 | <0.0001 | 66.2 ± 16.2 | 77.5 ± 20.0 | −2.4, 28 | 0.020 |
Sling plasty angle of the mouth | 8.2 ± 2.2 | 9.3 ± 1.3 | −2.5, 15 | 0.023 | 62.8 ± 14.3 | 52.4 ± 10.7 | 21.2, 13 | 0.056 |
Eyelid surgery, any | 7.2 ± 2.9 | 6.1 ± 3.1 | 3.7, 91 | <0.0001 | 61.6 ± 17.1 | 64.0 ± 19.4 | −2.1, 52 | 0.042 |
Upper eyelid weight | 7.7 ± 2.5 | 6.4 ± 3.0 | 4.1, 76 | <0.0001 | 61.2 ± 17.9 | 63.2 ± 20.6 | −1.8, 42 | 0.072 |
Tarsorrhaphy | 7.0 ± 2.5 | 5.9 ± 2.8 | 0.9, 8 | 0.384 | 59.0 ± 14.7 | 62.1 ± 16.3 | −0.6, 7 | 0.550 |
Kanthopexy | 7.8 ± 2.5 | 8.2 ± 2.3 | −0.4, 11 | 0.701 | 63.0 ± 13.7 | 42.3 ± 21.0 | 1.8, 5 | 0.135 |
Brow plasty | 7.2 ± 3.1 | 6.7 ± 3.6 | 0.8, 21 | 0.451 | 67.1 ± 15.4 | 60.5 ± 23.8 | 0.8, 12 | 0.427 |
Blepharoplasty | 4.4 ± 3.6 | 4.5 ± 2.8 | −0.1, 14 | 0.896 | 57.3 ± 17.3 | 65.3 ± 16.6 | −2.6, 12 | 0.025 |
Lower lid plasty | 8.6 ± 1.9 | 7.8 ± 2.3 | 1.7, 24 | 0.100 | 59.5 ± 23.2 | 57.7 ± 25.2 | −1.4, 12 | 0.811 |
Physical therapy/speech therapy | 5.9 ± 3.0 | 3.3 ± 3.0 | 7.9, 96 | <0.0001 | 62.5 ± 14.9 | 70.3 ± 19.4 | −5.4, 65 | 0.002 |
Electrotherapy | 7.3 ± 2.3 | 5.9 ± 2.9 | 4.1, 52 | <0.0001 | 62.1 ± 15.9 | 70.8 ± 17.1 | 3.9, 46 | <0.0001 |
Botulinumtoxin injection | 3.7 ± 2.9 | 2.3 ± 1.9 | 6.4, 159 | <0.0001 | 60.6 ± 15.9 | 72.0 ± 15.7 | −6.7, 110 | <0.0001 |
Eye moisture chamber | 6.0 ± 2.4 | 1.3 ± 2.4 | 32.6, 434 | <0.0001 | 65.0 ± 17.8 | 65.0 ± 17.8 | −2.6, 87 | 0.010 |
Eye drops/ointment | 5.9 ± 2.5 | 1.3 ± 2.4 | 32.1, 448 | <0.0001 | 65.7 ± 16.6 | 78.7 ± 16.6 | −7.7, 112 | <0.0001 |
Facial exercises at home | 5.4 ± 2.6 | 1.0 ± 2.0 | 31.8, 452 | <0.0001 | 68.7 ± 16.1 | 80.8 ± 16.6 | −5.5, 85 | <0.0001 |
Facial EMG biofeedback training | 3.8 ± 2.8 | 2,8 ± 2.0 | 7.3, 284 | <0.0001 | 63.1 ± 1.2 | 74.3 ± 15.3 | −10.2, 195 | <0.0001 |
FaCE, Total Score | SF-36, General Health | |||||||
---|---|---|---|---|---|---|---|---|
First Visit Mean ± SD | Last Visit Mean ± SD | T, df | p | First Visit Mean ± SD | Last Visit Mean ± SD | T, df | p ** | |
All | 53.8 ± 20.0 | 67.3 ± 20.8 | −15.8, 613 | <0.0001 | 58.4 ± 19.6 | 61.9 ± 21.7 | −3.7, 599 | <0.0001 |
Glucocorticoids | 60.1 ± 21.5 | 80.8 ± 20.0 | −10.2, 322 | <0.0001 | 59.0 ± 16.7 | 65.0 ± 21.8 | −2.3, 309 | 0.014 |
Acyclovir | 62.8 ± 19.4 | 83.8 ± 16.9 | −8.0, 158 | <0.0001 | 58.2 ± 17.5 | 65.0 ± 23.4 | −2.3, 140 | 0.028 |
Glucocorticoids± Acyclovir | 60.5 ± 20.8 | 82.6 ± 17.9 | −8.7, 177 | <0.0001 | 59.6 ± 17.5 | 64.4 ± 22.9 | −2.0, 171 | 0.047 |
Antibiotics | 53.2 ± 20.5 | 80.7 ± 27.8 | −6.9, 17 | <0.0001 | 54.4 ± 24.1 | 65.4 ± 19.7 | −0.6, 14 | 0.066 |
Facial nerve reconstruction, any | 54.9 ± 19.3 | 60.6 ± 18.7 | −3.1, 32 | 0.005 | 59.0 ± 24.3 | 61.2 ± 13.5 | −0.5, 26 | 0.601 |
Facial–facial nerve suture | 70.8 ± 18.5 | 68.1 ± 15.9 | 0.4, 1 | 0.783 | 59.5 ± 10.4 | 53.5 ± 15.6 | 6.0, 1 | 0.105 |
Facial nerve interpositional graft | 51.7 ± 11.7 | 53.0 ± 8.4 | −0.1, 3 | 0.917 | 64.6 ± 10.4 | 61.5 ± 15.6 | 0.8, 3 | 0.469 |
Hypoglossal–facial-nerve jump suture | 51.0 ± 18.5 | 59.3 ± 18.2 | −3.1, 28 | 0.005 | 58.6 ± 26.9 | 61.2 ± 14.9 | −0.7, 22 | 0.469 |
Sling plasty angle of the mouth | 30.0 ± 4.7 | 29.2 ± 8.3 | 0.1, 2 | 0.942 | 42.5 ± 10.6 | 48.5 ± 12.0 | −0.4, 4 | 0.772 |
Eyelid surgery, any | 46.9 ± 18.1 | 50.7 ± 21.1 | −2.5, 51 | 0.015 | 56.7 ± 23.9 | 54.2 ± 18.3 | 0.9, 47 | 0.390 |
Upper eyelid weight | 48.1 ± 19.8 | 50.6 ± 23.1 | −2.0, 42 | 0.048 | 54.8 ± 25.4 | 53.8 ± 17.8 | 0.4, 37 | 0.671 |
Tarsorrhaphy | 41.7 ± 15.0 | 49.7 ± 14.3 | −4.7, 6 | 0.009 | 48.5 ± 19.1 | 53.5 ± 5.0 | −0.3, 6 | 0.818 |
Kanthopexy | 44.7 ± 17.3 | 39.4 ± 17.2 | 0.9, 5 | 0.422 | 48.5 ± 2.1 | 40.0 ± 0 | 5.7, 5 | 0.111 |
Brow plasty | 53.0 ± 15.5 | 55.2 ± 20.1 | −0.4, 9 | 0.675 | 54.7 ± 10.8 | 50.7 ± 18.5 | 0.9, 7 | 0.475 |
Blepharoplasty | 44.9 ± 17.9 | 49.8 ± 23.2 | −1.1, 11 | 0.300 | 57.4 ± 14.1 | 53.0 ± 19.1 | 0.8, 12 | 0.462 |
Lower lid plasty | 53.0 ± 21.3 | 55.0 ± 25.0 | −0.4, 12 | 0.630 | 54.0 ± 36.2 | 47.3 ± 31.6 | 1.4, 9 | 0.184 |
Physical therapy/speech therapy | 52.1 ± 20.3 | 62.5 ± 20.3 | −5.9, 61 | <0.0001 | 54.7 ± 14.7 | 55.8 ± 12.5 | −0.2, 56 | 0.586 |
Electrotherapy | 45.5 ± 18.1 | 54.4 ± 20.6 | −4.7, 45 | <0.0001 | 56.0 ± 18.8 | 57.1 ± 21.8 | −0.4, 44 | 0.715 |
Botulinumtoxin injection | 50.5 ± 19.7 | 61.1 ± 17.1 | −6.5, 110 | <0.0001 | 53.7 ± 20.2 | 62.1 ± 23.4 | −1.9, 84 | <0.0001 |
Eye moisture chamber | 57.4 ± 22.2 | 78.7 ± 22.2 | −9.2, 73 | <0.0001 | 58.5 ± 18.3 | 66.5 ± 22.8 | −2.6, 69 | 0.013 |
Eye drops/ointment | 57.2 ± 21.4 | 77.6 ± 22.3 | −10.0, 108 | <0.0001 | 59.4 ± 17.4 | 66.6 ± 22.9 | −1.9, 107 | 0.020 |
Facial exercises at home | 63.3 ± 18.5 | 81.6 ± 18.5 | −7.4, 72 | <0.0001 | 59.5 ± 16.8 | 64.7 ± 22.8 | −1.8, 60 | 0.076 |
Facial EMG biofeedback training | 52.0 ± 17.9 | 63.9 ± 16.6 | −10.7, 190 | <0.0001 | 61.2 ± 21.6 | 61.5 ± 19.2 | −0.9, 127 | 0.932 |
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Steinhäuser, J.; Volk, G.F.; Thielker, J.; Geitner, M.; Kuttenreich, A.-M.; Klingner, C.M.; Dobel, C.; Guntinas-Lichius, O. Multidisciplinary Care of Patients with Facial Palsy: Treatment of 1220 Patients in a German Facial Nerve Center. J. Clin. Med. 2022, 11, 427. https://doi.org/10.3390/jcm11020427
Steinhäuser J, Volk GF, Thielker J, Geitner M, Kuttenreich A-M, Klingner CM, Dobel C, Guntinas-Lichius O. Multidisciplinary Care of Patients with Facial Palsy: Treatment of 1220 Patients in a German Facial Nerve Center. Journal of Clinical Medicine. 2022; 11(2):427. https://doi.org/10.3390/jcm11020427
Chicago/Turabian StyleSteinhäuser, Jonathan, Gerd Fabian Volk, Jovanna Thielker, Maren Geitner, Anna-Maria Kuttenreich, Carsten M. Klingner, Christian Dobel, and Orlando Guntinas-Lichius. 2022. "Multidisciplinary Care of Patients with Facial Palsy: Treatment of 1220 Patients in a German Facial Nerve Center" Journal of Clinical Medicine 11, no. 2: 427. https://doi.org/10.3390/jcm11020427