Assessing impairment and disability of facial paralysis in patients with vestibular schwannoma

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 1), 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.