Documentation and Imaging in Facial Palsy

Abstract

The myriad etiologies, symptoms on presentation, and clinical course pose a substantial sum of variables that affect reconstructive planning and outcome tracking for the facial palsy patient. Thus, standardized and detailed documentation are of paramount importance for assessing the need for reconstruction, surgical planning, and tracking outcomes. To date, while no universally standardized method of facial palsy documentation exists, substantive methods incorporate the factors of disease etiology, degree of facial nerve involvement, presence of synkinesis, and progression of symptoms. To this end, standardized scales such as the House–Brackmann, Chuang Smile Excursion Score, and others are indispensable for characterizing defects and tracking outcomes. Modern photo-videography offers further essential tools for tracking outcomes, and the patient should be recorded with attention to the at rest and voluntary contraction of the muscles in each facial nerve division. Attention must also be paid to the presence of synkinesis. While it remains up to the surgeon to determine which methods suit his or her practice best, it remains important to employ consistent and thorough documentation for the purposes of reconstructive planning, tracking a clinical course, and measuring outcomes.