Characteristics of Perception for Facial Nerve Palsy

Abstract

Introduction: The aim of this study was to investigate the characteristics of the perception of the facial nerve palsy (FNP). Subjects and Methods: A questionnaire survey of 200 healthy people was performed between July and September in 2012, using photographs of four patients with four different grades of unilateral FNP (resting, smiling, whistling, closed eyes, and frowning). The questionnaire consisted of questions concerning the identification of FNP, the involved side of the face, the awkward-appearing areas of the face, and the awkwardness of the facial expressions. The education level of the subjects was also surveyed. Results: One hundred males and 100 females ranging in age from 20 to 69 years were enrolled in this study. The overall rate of identification of FNP was 75.0%. There was no significant difference in the rate of identification of FNP according to the gender or the age of the subjects, whereas the identification rate increased according to the increase in the House-Brackmann grade of the patients FNP (p <.001, linear by linear test). The overall detection rate of the involved side of the face was 54.5%, and that rate decreased with increasing subject age (p <.001, linear by linear test). The most awkward-appearing area of the face was reported to be the mouth, followed by the eyes, the cheeks, the eyebrows, and the nose. The most awkward facial expression was reported to be smiling, followed by closed eyes, whistling, and frowning. There was no difference in the rate of identification of FNP according to the education level. However, the overall detection rate for the side of the face affected by FNP was higher in the high-education group (p < .001, chi-squared test). Conclusions: The detection rate for the side of the face affected by FNP was lower than the rate of identification of FNP and was significantly low in the middle-aged/elderly and the low-education level groups. These characteristics must be considered in establishing a new FNP grading system.