A simple objective evaluation and grading for facial paralysis outcomes

Abstract

Conclusion: A simple measuring box to determine lip-shift angle and eye-width narrowing offered simultaneous and objective data on outcome dysfunction. The method is as easy as visual approaches. The method is objective and as easy as visual access. It is practical for routine clinical use in any clinic. Objectives: The outcome dysfunction after facial paralysis is commonly evaluated by subjective visual access. This paper introduces a new method for simple objective evaluation and grading with documentation of lip-shift and eye-width changes. Methods: Thirty adult controls were used to determine standard deviations (SDs) for angular shift of the lip at rest and eye-width narrowing at maximum lip protrusion. Thirty patients with facial paralysis more than 6 months after onset were studied for outcomes in terms of synkinesis, contracture, and lip deviation to the healthy side. Abnormalities were read with a simple measuring box. Results: Among the controls, mean lip shift at rest and its SD were 0° and 1.2. Mean eye narrowing at maximum lip protrusion effort and its SD were –0.6 mm and 1.6. This paper proposes a new grading system that relies simply on the sum of evaluating items exceeding 2 SDs, or residual lip deviation to the healthy side.

Keywords::

• Measuring tool
• lip-shift angle
• eye narrowing
• synkinesis
• contracture
• residual paralysis

Declaration of interest: The author reports no conflicts of interest. The author alone is responsible for the content and writing of the paper.