Measuring outcomes in facial palsy treatment: adding extra dimensions to a complex matter

Author(s):  
Sjaak Pouwels ◽  
Salvatore Sanfilippo ◽  
Eloise Owen ◽  
Koen J. A. O. Ingels ◽  
Frank W. De Jongh ◽  
...  
2020 ◽  
pp. 000348942095737
Author(s):  
Natalie A. Krane ◽  
Jimmy S. Chen ◽  
Haley Hanseler ◽  
Wenelia Baghoomian ◽  
John Ng ◽  
...  

Objectives: Nerve transfer (NT) and free gracilis muscle transfer (FGMT) are procedures for reanimation of the paralyzed face. Assessing the surgical outcomes of these procedures is imperative when evaluating the effectiveness of these interventions, especially when establishing a new center focused on the treatment of patients with facial paralysis. We desired to discuss the factors to consider when implementing a facial nerve center and the means by which the specialist can assess and analyze outcomes. Methods: Patients with facial palsy secondary to multiple etiologies, including cerebellopontine angle tumors, head and neck carcinoma, and trauma, who underwent NT or FGMT between 2014 and 2019 were included. Primary outcomes were facial symmetry and smile excursion, calculated using FACE-gram and Emotrics software. Subjective quality of life outcomes, including the Facial Clinimetric Evaluation (FaCE) Scale and Synkinesis Assessment Questionnaire (SAQ), were also assessed. Results: 14/22 NT and 6/6 FGMT patients met inclusion criteria having both pre-and postoperative photo documentation. NT increased oral commissure excursion from 0.4 mm (SD 5.3) to 2.9 mm (SD 6.8) ( P = 0.05), and improved symmetry of excursion ( P < 0.001) and angle ( P < 0.001). FGMT increased oral commissure excursion from −1.4 mm (SD 3.9) to 2.1 mm (SD 3.7), ( P = 0.02), and improved symmetry of excursion ( P < 0.001). FaCE scores improved in NT patients postoperatively ( P < 0.001). Conclusions: Measuring outcomes, critical analyses, and a multidisciplinary approach are necessary components when building a facial nerve center. At our emerging facial nerve center, we found NT and FGMT procedures improved smile excursion and symmetry, and improved QOL following NT in patients with facial palsy secondary to multiple etiologies.


2003 ◽  
Vol 11 (2) ◽  
pp. 2-5
Author(s):  
Harvey B. Abrams ◽  
Theresa Hnath Chisolm
Keyword(s):  

2013 ◽  
Vol 44 (02) ◽  
Author(s):  
J Brunner ◽  
RW Reinhard ◽  
LB Zimmerhackl

2015 ◽  
Vol 76 (S 01) ◽  
Author(s):  
Lucas Carlstrom ◽  
William Copeland ◽  
Brian Neff ◽  
Colin Driscoll ◽  
Michael Link

Skull Base ◽  
2008 ◽  
Vol 18 (S 01) ◽  
Author(s):  
Tony Cheesman
Keyword(s):  

2016 ◽  
Vol 4 (1) ◽  
pp. 20-40
Author(s):  
Ines Oswald

This paper investigates grocery store selection among Germans in Greater London compared to native UK residents. Since consumers hold so much power, the grocery retail sector is highly competitive. Additionally, understanding consumer behaviour in urban areas with large numbers of foreign nationals is a complex matter. As internationalisation continues borders are becoming increasingly blurred. Therefore, it is crucial for managers of grocery stores to understand potential cultural differences in terms of store choice. The survey examined the changes, if any, in store choice determinants among Germans living in Greater London compared retrospectively to when they were living in Germany. To provide a comparison, a small group of native UK consumers were also surveyed. The resulting comparison revealed some significant differences and changes in grocery store selection over time. These findings are also likely to be useful for managers in the grocery retail sector when addressing the dynamic nature of transnational mobile and connected consumer markets.


2019 ◽  
Author(s):  
Suci Handayani Handayani ◽  
Hade Afriansyah

Decision making is one element of economic value, especially in the era of globalization, and if it is not acceptable in the decision making process, we will be left behind. According to Robins, (2003: 173), Salusu, (2000: 47), and Razik and Swanson, (1995: 476) say that decision making can be interpreted as a process of choosing a number of alternatives, how to act in accordance with concepts, or rules in solving problems to achieve individual or group goals that have been formulated using a number of specific techniques, approaches and methods and achieve optimal levels of acceptance.Decision making in organizations whether a decision is made for a person or group, the nature of the decision is often determined by rules, policies, prescribed, instructions that have been derived or practices that apply. To understand decision making within the organization it is useful to view decision making as part of the overall administrative process. In general, individuals tend to use simple strategies, even if in any complex matter, to get the desired solution, because the solution is limited by imperfect information, time and costs, limited thinking and psychological stress experienced by decision makers.


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