Exploring patient values and perceptions with facial nerve palsy to help guide management: An Australian perspective

Abstract

**Background**: Facial nerve palsy (FNP) leads to a combination of aesthetic and functional deficits with profound psychosocial consequences. Significant advances have been made in restoring dynamic function through a range of facial reanimation solutions. Patient-reported severity scales are predetermined metrics that provide limited insight into patient values and perceptions. A qualitative study was conducted to elicit the experiences of patients with FNP and explore their views and motivations for seeking therapy. **Methods**: Participants were sourced from the Sydney Head and Neck Cancer Institute Database, Australia. Eligibility for the study included age over 18 years and a diagnosis of complete FNP. Semi-structured interviews were conducted and the transcripts were subjected to thematic text analysis. **Results**: Nineteen patients consented to participate in the study. One was excluded due to an isolated marginal mandibular nerve palsy. Five main themes emerged: eye symptoms, fear of judgement and social withdrawal, aversion to further invasive surgeries, the need for multidisciplinary streamlined care and lack of public awareness. **Conclusion**: Eye symptoms and the social consequences of FNP carry significant impact on both patients’ personal and professional lives. There is a paucity of services that can support patients across the complex spectrum of problems seen in FNP.