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Updated: Jul 18, 2025
Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Analysis of Predictive Factors for the Poor Prognosis of Peripheral Facial Paralysis
Emilio Javier Frutos-Reoyo1, Raúl López-Izquierdo, Paula Luque-Linero
1From the Servicio de Medicina Física y Rehabilitación, Hospital Universitario Río Hortega, Valladolid, Spain (EJF-R, EC-P, MJA-A, EDC-P); Servicio de Urgencias, Hospital Universitario Río Hortega, Valladolid, Spain (RL-I, JMH-G); Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Sevilla, Spain (PL-L); Servicio de Medicina Física y Rehabilitación, Hospital Virgen de la Concha, Zamora, Spain (EC-P).
Purpose:
The aim of the study is to evaluate the predictive factors for a poor prognosis in patients with facial paralysis evaluated in the rehabilitation department of a tertiary hospital.
Methods:
We have conducted a prospective cohort study. Patients who required elective botulinum toxin infiltration, surgical treatment, or follow-up appointments longer than 6 months due to incomplete recovery were considered to have a poor prognosis. Descriptive and analytical analyses of clinical and epidemiological variables were performed. The follow-up period was 6 mos.
Results:
A total of 47 adult patients were analyzed, 54.2% of whom were women. The mean age was 53.2 yrs (SD, 15.5 yrs). Twenty-five percent had an unfavorable prognosis. A statistically significant association with prognosis was observed for neurophysiological results and the scores of the House-Brackmann scale and the Sunnybrook Facial Grading System.
Conclusions:
Neurophysiological tests are especially useful when evaluating prognosis. Likewise, Sunnybrook Facial Grading System is a useful and accessible tool with prognostic value, especially within a month of initial diagnosis, when a score lower than 65 indicates a poor prognosis with high sensitivity and specificity. These tools can be especially useful to reduce the clinical and psychological impact and to provide patients with early therapeutic management.
