Evaluating Quality Of Life After Facial Reanimation Using The Facial Clinimetric Evaluation Scale In A Series Of Pediatric Patients

Background: Facial palsy can have significant functional and psychological impact. Dynamic facial reanimation methods have provided means of restoration of smile. There remains a dearth of quality of life data in children. The authors aim to assess patient reported outcomes in this underreported population. Methods: A retrospective review was performed of pediatric patients with facial palsy who had dynamic facial reanimation from 2009 to 2017 at a single institution. Patients were sent a digital Facial Clinimetric Evaluation (FaCE) questionnaire, a validated tool to assess patient quality of life. FaCE statements are grouped into 6 categories: facial movement, facial comfort, oral function, eye comfort, lacrimal control, and social control. Results: Twenty patients met inclusion criteria. Fourteen successfully completed the survey. With normal function being 100, our cohort scored: facial movement 38.7 +/- 14.3; facial comfort 67.3 +/- 23, oral function 75 +/- 22.7, eye comfort 68.75 +/- 18.2, lacrimal control 53.6 +/- 32.5, social function 64.3 +/- 25.6. The overall FaCE score was 61.07 +/- 10.85. The facial movement subscores were lower for brow raise 16.1 +/- 33.4 relative to smiling 53.6 +/- 29.2 and lip pucker, 46.4 +/- 23.7. No correlation was found between facial movement scores and total scores (R-2 < 0.01). There was a strong negative correlation between total scores and time since procedure (Spearman's rho R = -0.45). Conclusion: Our pediatric facial reanimation cohort demonstrated excellent social function, in contrast to a relatively lower facial movement score. The low facial movement score was mediated by low score for brow raise and was not correlated to overall FaCE score. Interestingly, overall FaCE score tended to decrease with time from procedure.