Speech Intelligibility in Patients with Facial Paralysis

Area of Science:

• Neurology
• Speech-Language Pathology
• Otolaryngology

Background:

• Facial paralysis significantly impacts patient communication and quality of life.
• Limited data exist on speech intelligibility deficits in individuals with facial paralysis.
• Understanding factors influencing intelligibility is crucial for targeted interventions.

Purpose of the Study:

• To compare speech intelligibility in patients with varying degrees of facial paralysis (severe vs. non-severe).
• To assess the impact of synkinesis on speech intelligibility.
• To identify a quantitative measure (Sunnybrook scale) predictive of intelligibility deficits.

Main Methods:

• Retrospective review of video and audio data from 80 patients.
• Stratification into three groups: severe paralysis without synkinesis, non-severe without synkinesis, and non-severe with synkinesis.
• Speech intelligibility assessment by laypeople and a speech-language pathologist (SLP) using the Frenchay Dysarthria Assessment Version 2 (FDA-2).
• Receiver operating characteristic (ROC) curve analysis to determine the Sunnybrook scale cutoff for intelligibility abnormality.

Main Results:

• A Sunnybrook facial paralysis score of ≤18.5 was identified as a predictor of intelligibility deficiency.
• Speech-language pathologists identified intelligibility abnormalities in 28.7% of cases, compared to 15.0% by laypeople.
• Patients with synkinesis demonstrated better speech intelligibility compared to those without synkinesis.

Conclusions:

• A Sunnybrook score of 18.5 or lower indicates a higher likelihood of speech intelligibility impairment in facial paralysis patients.
• Speech-language pathologists possess a more refined ability to detect intelligibility deficits than untrained observers.
• The presence of synkinesis may positively influence speech intelligibility in individuals with facial paralysis.