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John Lee, MD; Kevin Fung, MD, FRCSC; Steven P. Lownie, MD, FRCSC, FACS; Lorne S. Parnes, MD, FRCSC

Arch Otolaryngol Head Neck Surg. 2007;133(1):56-60.

Objective  To evaluate facial impairment and disability with respect to quality of life in patients with facial paresis after vestibular schwannoma surgery.

Design  Cross-sectional observational study.

Setting  Academic, tertiary care hospital.

Patients  All consecutive patients during a 5-year period who underwent vestibular schwannoma surgery.

Main Outcome Measures  The validated, patient-graded Facial Clinimetric Evaluation (FaCE) scale questionnaire was administered to all study patients. Main outcome measures included total and social function FaCE scores. Subgroup analysis was performed on patient factors (age and sex), surgical factors (tumor size and time since operation), and House-Brackmann grade.

Results  A total of 56 FaCE questionnaires were returned (85% response rate): 28 patients (50%) had normal facial function (House-Brackmann grade I), and 28 patients (50%) had abnormal facial function (House-Brackmann grades II-VI). There were no demographic differences between the normal and abnormal groups. The normal group had a total FaCE score of 96.2 compared with 67.1 in the abnormal group (P<.05). Subgroup analysis of patients with facial paresis revealed that age, sex, time since operation, tumor size, and House-Brackmann grade were not statistically significant factors predicting the FaCE social function score (P<.05).

Conclusions  Facial paresis is an important complication of vestibular schwannoma surgery and will impair a patient's quality of life. The level of impairment may not be predicted by a patient's age, sex, tumor size, time since operation, or severity of facial paresis.

Author Affiliations: Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario (Dr Lee); and Department of Otolaryngology (Drs Fung and Parnes) and Division of Neurosurgery (Dr Lownie), University of Western Ontario, London, Ontario.

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