Utility Outcome Scores for Unilateral Facial Paralysis

作者：Sinno Hani; Thibaudeau Stephanie; Izadpanah Ali; Tahiri Youssef; Christodoulou George; Zuker Ronald; Lin Samuel J^*

来源：Annals of Plastic Surgery, 2012, 69(4): 435-438.

DOI：10.1097/SAP.0b013e318246e698

• facial paralysis
• utility scores
• QALY
• facial nerve reconstruction

Background: Facial paralysis is a debilitating condition. Dynamic and static facial reanimation remains a challenge for plastic surgeons and requires important resources. Our objective was to quantify the health state utility assessment (ie, utility score outcomes) of living with unilateral facial paralysis.
Methods: Utility assessments using visual analog scale, time trade-off, and standard gamble were used to obtain utility outcome scores for unilateral facial paralysis from a prospective sample of the general population and medical students.
Results: A total number of 123 individuals prospectively participated in the study. All measures (visual analog scale, time trade-off, and standard gamble) for unilateral facial paralysis [0.56 +/- 0.18, 0.78 +/- 0.21, and 0.79 +/- 0.21 respectively] were significantly different (P < 0.0001) from the corresponding outcome scores for monocular blindness [0.61 +/- 0.21, 0.83 +/- 0.21, and 0.85 +/- 0.18, respectively] and binocular blindness [0.33 +/- 0.18, 0.65 +/- 0.28, and 0.65 +/- 0.29, respectively]. Linear regression analysis using age, race, income, and education as predictors of each of the utility scores for facial paralysis showed no statistical significance.
Conclusions: In samples of the general population and medical students, all utility score outcome measures for facial paralysis were lower than those for monocular blindness. Our sample population, if faced with unilateral facial paralysis, would theoretically undergo facial reanimation procedures with a willingness to sacrifice 8 years of life and be willing to undergo a procedure with a 21% chance of mortality to attain perfect health, respectively.