CLINICO-EPIDEMIOLOGICAL PATTERN OF FACIAL NERVE PALSY IN EKITI

Waheed Atilade Adegbiji; Shuaib Kayode Aremu; Fatai Olatoke; Anthony Oyebanji Olajuyin

Volume : VII, Issue : I, January - 2018

CLINICO-EPIDEMIOLOGICAL PATTERN OF FACIAL NERVE PALSY IN EKITI

Waheed Atilade Adegbiji, Shuaib Kayode Aremu, Fatai Olatoke, Anthony Oyebanji Olajuyin

Abstract :

Background: Facial nerve supply muscle of facial expression. Its damage causes functional disability and cosmetically affects the quality of life of the patients.

This study is aimed at determining the sociodemographic distributions, aetiology, clinical presentation, complications and quality of life of patients with facial nerve palsy.

Method: This is a prospective hospital based study of patients with facial nerve palsy. The study was conducted at Ekiti state university teaching hospital Ado Ekiti, Nigeria.

This study was carried out in ear, nose and throat department of the institution over a period of nine years (April 2008 to March 2017).

Ethical clearance was obtained, and consented participants were enrolled into the study. Information obtained were treated confidentially.

Interviewer’s assisted questionnaire were administered to obtain data on demographic features, presenting complaints with associated clinical features, source of referral, complications, quality of life and treatment of facial nerve palsy patients.

Data obtained were collated, entered into database and analyzed by SPSS version 16 software. Descriptive statistics was used and expressed with table, pie charts and bar charts.

Results: The total number of patients seen in ear, nose and throat department, during this study, was 19,714 while a total of 207 patients were diagnosed with facial nerve palsy. The prevalence of facial nerve palsy was 1.1%. There were 60.9% males, and the male to female ratio was 3:2 in this study.

The peak age group accounted 35.7% at (21–30) years.

The married and single were the majority, and accounted for 61.4% and 31.4% respectively. Education status of the enrolled participants were: secondary– 42.9% and post–secondary– 31.9%.

Occupational predisposition were students/apprentice and civil servant; they accounted for 26.6% and 24.2% respectively.

The commonest causes of facial nerve palsy were Bell’s palsy, temporal bone fracture, and iatrogenic injuries, which accounted for 40.1%, 16.9% and 8.2% respectively. The less common causes were malignant otitis externa, middle ear tumor, and chronic suppurative otitis media which were responsible for 1.9% 3.9% and 4.8% respectively.

Clinical presentation of facial nerve palsy in the study population were mainly 98.6% facial asymmetry, 95.7% mouth deviation, and 90.3% inability to close eye.

Lesser number presenting complaints were 22.7% taste affectation, 26.6% speech affectation, and 47.3% teå.

Lower motor neuron lesion 87.4% was commoner than upper motor neuron lesion 12.6%. Unilateral facial nerve palsy 99.0% predominate bilateral facial nerve palsy1.0%.

Right facial nerve palsy 58.9% was also commoner than left facial nerve palsy40.1%.

The major complications of facial nerve palsy were 16.4% facial asymmetry and 6.3% hemifacial spasms.

The lesser complications accounted for 2.4% gustatory lacrimation, and 1.4% synkinesis.

Sources referred for the otorhinolaryngological, head and neck review and management, were mainly from 63.3% general practitioner, 12.0% neurologist, and 12.6% self reporting.

Majority of facial nerve palsy affectation of quality of life occurred as 81.2% self–reported less attractiveness and 68.1% lower mood.

Lesser affectation of quality of life occurred as 46.9% depression and 36.2% low self–esteem.

Majority like 90.3% of the patients, were treated conservatively with drugs and physiotherapy while minority like 9.7% had surgical intervention. Full recovery occurred in 78.3% of the cases, 7.7% had partial recovery, while in 14.0%, the outcome was unsatisfactory.

Conclusion: Facial nerve palsy causes loss of function of muscle of facial expression. Complicated cases include emotional distress and ocular manifestation. Managing team must consider quality of life affection to achieve an excellent outcome.