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Fasiyal Paralizili Hastalarda Başvuru Süresi ile Paralizi Derecesi Arasındaki İlişki

Year 2019, , 544 - 549, 16.09.2019
https://doi.org/10.31832/smj.562018

Abstract

Fasiyal Paralizili Hastalarda Başvuru Süresi İle Paralizi Derecesi
Arasındaki İlişki



     ÖZET



Amaç: Fasiyal
paralizi (FP)
sıklıkla idiopatik ve takiben travmatik
etiolojiyle ortaya çıkan kişide yıkıcı etkileri olan bir hastalıktır. FP süresi
ve şiddetinin tedavi ve prognozda belirleyici etkisi vardır. Bu nedenle
çalışmamızda FP semptomları göstermeye başlamış hastaların sağlık kuruluşlarına
başvurusuna kadar geçen süreyi etkileyebilecek olası klinik ve demografik
faktörleri
değerlendirmeyi amaçladık.



Yöntem: Çalışmaya fasiyal
paralizi
semptomları ile kliniğimize son bir yıl
içinde başvuru yapmış
toplam 100 olgu retrospektif
olarak
dahil edilmiştir. Fasiyal paralizili hastaların
değerlendirmesinde
House-Brackmann
Skorlama (HBS) sistemi kullanılmıştır.
HBS
sistemine göre hastalar artan fonksiyon kaybı ve hastalık şiddetine uygun grade
1'den grade 6'ya kadar sınıflandırılmıştır.
Elde edilen tüm klinik ve sosyo-demografik
veriler kaydedilerek başvuru süresi açısından karşılaştırılmıştır.



Bulgular: Yaş ortalaması 56,30±17,78
yıl olan 47'si kadın (%47,0), 53'ü erkek (%53,0) toplam 100
fasiyal paralizli hastadan; ağırlıklı olarak idiopatik
etioloji ile (%82,0) ilişkilendirilen olguların; %95,0'i (n=95) PFP, %5’i (n=5)
SFP olarak tespit edilmiştir. Ortalama başvuru süresi
2,76±2,07 (Dağılım Aralığı=1-7 gün) gün olan hastalar HBS sistemine göre sınıflandırıldığında; %40,0 (n=40) oranıyla en sık
grade 3
fasiyal paralizi
gözlenmiştir
.Olguların
ortalama başvuru süreleri HBS’ye göre değerlendirildiğinde gruplar arasında
istatistiksel
olarak anlamlı farklılık saptanmıştır (p=0,003). Öyle ki
grade 6 grubunda en kısa
ortalama başvuru süresi (
1,63±1,061 gün) izlenmiştir. Bunlara ek olarak HBS ile ortalama başvuru süreleri
arasında negatif yönde istatistiksel olarak anlamlı bir korelasyon ilişkisi
tespit edilmiştir (r=-389, p=0,000).
Ancak
hastaların FP lokalizasyonu, FP tipi, komorbid sistemik hastalık
öyküsü, cinsiyet
ve ikamet yeri uzaklığının ortalama
başvuru süresine anlamlı bir etkisi olmadığı belirlenmiştir (p>0,05).



Sonuç:
Çalışmamızda ilk
kez FP hastalarının ortalama başvuru süresini etkileyebilecek olası klinik ve demografik
faktörleri
değerlendirilmiş olup; artan hastalık şiddetinin başvuru süresini anlamlı
şekilde kısalttığı belirlenmiştir. FP hastalarında erken tedavinin fizyolojik,
anatomik ve psikolojik iyileşmeye olan major etkisi göz önüne alındığında,
düşük grade FP semptomları gösteren hastaların sağlık kuruluşlarına başvurusunu
hızlandıracak tedbirlerin alınmasının hastalığın yönetimine katkı sağlayacağı
kanaatindeyiz.



Anahtar
Kelimeler:
Fasiyal paralizi; Yüz felci; Bell
paralizisi
; Periferik Yüz felci; Başvuru Süresi.



The Association Between Severity of Paralysis and Duration of Admission
in Patients with Facial Paralysis



ABSTRACT



Background and Aim:  Facial
paralysis (FP) is a disease that has devastating effects in individuals with
majority of idiopathic etiology. FP duration and severity have a prominent
impact on treatment and prognosis.
Therefore,
we aimed to evaluate the possible clinical and demographic factors that might
affect the
duration of application to health
institutions in patients with FP symptoms.



Methods: A total number of 100 patients with symptoms of
facial paralysis, who were admitted to our clinic within the last year, were included
in this study retrospectively. House-Brackmann Scoring (HBS) system was
utilized in the evaluation of patients with FP.
Patients were classified from grade 1 to grade 6 based on
increased function loss and disease severity according to the HBS.
All
clinical and socio-demographic data were recorded and compared in terms of
duration of admission.



Results: The 100
patients included in this study
were 53 (
53,0%) male and 47 (47,0%) female and the mean age of all patients was 56,30±17,78 years. The cases which are
predominantly (82.0%)  idiopathic
etiology were identified as 95.0% PFP and 5% as SFP.
The
average duration of admission was 2,76±2,07
(Ranged=1-7 days)
in our study sample. Of the patients
40,0% was classified as grade 3 FP according to the HBS. There
were statistically significant differences found in terms of admission duration according to the
HBS (p=0,003).
Supportively the shortest
average application
duration (1,63 ± 1,061 days) was
observed in grade 6 group. In addition.
There
were negative-moderate statistically significant correlation detected between HBS score and
average application duration (r=-389, p=0,000). There
were no statistically significant differences found in terms of
FP localization, FP type, history of comorbid systemic
disease, gender, and place of residence
according
to the
average application duration (p> 0.05).



Conclusions:
We evaluated the possible clinical and demographic factors that may affect the
mean admission duration of FP patients for the first time in the literature. It
was demonstrated that the increasing disease severity has significantly shorten
the application period. Considering the major effect of early treatment on
physiological, anatomical and psychological improvement in FP patients, taking measures
for earlier application of patients with low grade FP symptoms to health
institutions may contribute to management of the disease.



Key
Words:
Facial paralysis; Bell's palsy; Peripheral facial paralysis; Admission period.

Supporting Institution

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Project Number

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Thanks

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References

  • 1. Melvin TA, Limb CJ. Overview of facial paralysis: current concepts. Facial plastic surgery. 2008;24:155-163.
  • 2. Batman Ç, Binnetoğlu A. Travmatik Periferik Fasiyal Paralizi. Turkiye Klinikleri Journal of Ear Nose and Throat-Special Topics. 2016;9:51-55.
  • 3. Chan JY, Byrne PJ. Management of facial paralysis in the 21st century. Facial Plastic Surgery. 2011;27:346-357.
  • 4. Ho AL, Scott AM, Klassen AF, Cano SJ, Pusic AL, Van Laeken N. Measuring quality of life and patient satisfaction in facial paralysis patients: a systematic review of patient-reported outcome measures. Plastic and reconstructive surgery. 2012;130:91-99.
  • 5. Hadlock TA, Greenfield LJ, Wernick‐Robinson M, Cheney ML. Multimodality approach to management of the paralyzed face. The Laryngoscope. 2006;116:138-95.
  • 6. Bray D. Management of Facial Paralysis. Recent Advances in Surgery. 2013;30:35-73.
  • 7. Kang TS, Vrabec JT, Giddings N, Terris DJ. Facial nerve grading systems (1985–2002): beyond the House-Brackmann scale. Otology & neurotology. 2002;23:767-771.
  • 8. Lockhart P, Daly F, Pitkethly M, Comerford N, Sullivan F. Antiviral treatment for Bell's palsy (idiopathic facial paralysis). The Cochrane Library. 2010;2-12
  • 9. Kang NR, Tark MR, Byun SM, Ko WS, Yoon HJ. A Clinical analysis on 250 cases of Inpatients with Facial Paralysis. The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology. 2010;23:109-121.
  • 10. Garanhani MR, Rosa JC, Capelli AD, Ribeiro MC. Physical therapy in peripheral facial paralysis: retrospective study. Brazilian journal of otorhinolaryngology. 2007;73:106-109.
  • 11. Rowlands S, Hooper R, Hughes R, Burney P. The epidemiology and treatment of Bell’s palsy in the UK. European journal of neurology. 2002;9:63-67.
  • 12. Valença MM, Valença LP, Lima MC. Idiopathic facial paralysis (Bell´ s palsy): a study of 180 patients. Arquivos de Neuro-Psiquiatria. 2001;59:733-739.
  • 13. Savettieri G, Salemi G, Rocca WA, Meneghini F, Santangelo R, Morgante L, Coraci MA, Reggio A, Grigoletto F, Perri RD. Incidence and lifetime prevalence of Bell's palsy in two Sicilian municipalities. Acta neurologica scandinavica. 1996;94:71-75.
  • 14. Lee SM, Yang SP, Kim ES, Lee MJ, Park JM, Nam DW, Kang JW, Lee SH. Admission care for Bell’s palsy patients: a qualitative report on patient experiences. Journal of Korean Acupuncture & Moxibustion Society. 2013;30:11-23.
  • 15. Hong JM, Shin KM, Seo GM, Choi SY, Bae KR, Park JY, Baek YH, Nam DW, Lee YH. Clinical Comparison Study on Bell's Palsy Patients by the Period of Disease. Journal of Acupuncture Research. 2009;26:71-77.
  • 16. Chen WX, Wong V. Prognosis of Bell's palsy in children—analysis of 29 cases. Brain and development. 2005;27:504-508.
Year 2019, , 544 - 549, 16.09.2019
https://doi.org/10.31832/smj.562018

Abstract

Project Number

-

References

  • 1. Melvin TA, Limb CJ. Overview of facial paralysis: current concepts. Facial plastic surgery. 2008;24:155-163.
  • 2. Batman Ç, Binnetoğlu A. Travmatik Periferik Fasiyal Paralizi. Turkiye Klinikleri Journal of Ear Nose and Throat-Special Topics. 2016;9:51-55.
  • 3. Chan JY, Byrne PJ. Management of facial paralysis in the 21st century. Facial Plastic Surgery. 2011;27:346-357.
  • 4. Ho AL, Scott AM, Klassen AF, Cano SJ, Pusic AL, Van Laeken N. Measuring quality of life and patient satisfaction in facial paralysis patients: a systematic review of patient-reported outcome measures. Plastic and reconstructive surgery. 2012;130:91-99.
  • 5. Hadlock TA, Greenfield LJ, Wernick‐Robinson M, Cheney ML. Multimodality approach to management of the paralyzed face. The Laryngoscope. 2006;116:138-95.
  • 6. Bray D. Management of Facial Paralysis. Recent Advances in Surgery. 2013;30:35-73.
  • 7. Kang TS, Vrabec JT, Giddings N, Terris DJ. Facial nerve grading systems (1985–2002): beyond the House-Brackmann scale. Otology & neurotology. 2002;23:767-771.
  • 8. Lockhart P, Daly F, Pitkethly M, Comerford N, Sullivan F. Antiviral treatment for Bell's palsy (idiopathic facial paralysis). The Cochrane Library. 2010;2-12
  • 9. Kang NR, Tark MR, Byun SM, Ko WS, Yoon HJ. A Clinical analysis on 250 cases of Inpatients with Facial Paralysis. The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology. 2010;23:109-121.
  • 10. Garanhani MR, Rosa JC, Capelli AD, Ribeiro MC. Physical therapy in peripheral facial paralysis: retrospective study. Brazilian journal of otorhinolaryngology. 2007;73:106-109.
  • 11. Rowlands S, Hooper R, Hughes R, Burney P. The epidemiology and treatment of Bell’s palsy in the UK. European journal of neurology. 2002;9:63-67.
  • 12. Valença MM, Valença LP, Lima MC. Idiopathic facial paralysis (Bell´ s palsy): a study of 180 patients. Arquivos de Neuro-Psiquiatria. 2001;59:733-739.
  • 13. Savettieri G, Salemi G, Rocca WA, Meneghini F, Santangelo R, Morgante L, Coraci MA, Reggio A, Grigoletto F, Perri RD. Incidence and lifetime prevalence of Bell's palsy in two Sicilian municipalities. Acta neurologica scandinavica. 1996;94:71-75.
  • 14. Lee SM, Yang SP, Kim ES, Lee MJ, Park JM, Nam DW, Kang JW, Lee SH. Admission care for Bell’s palsy patients: a qualitative report on patient experiences. Journal of Korean Acupuncture & Moxibustion Society. 2013;30:11-23.
  • 15. Hong JM, Shin KM, Seo GM, Choi SY, Bae KR, Park JY, Baek YH, Nam DW, Lee YH. Clinical Comparison Study on Bell's Palsy Patients by the Period of Disease. Journal of Acupuncture Research. 2009;26:71-77.
  • 16. Chen WX, Wong V. Prognosis of Bell's palsy in children—analysis of 29 cases. Brain and development. 2005;27:504-508.
There are 16 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Doğukan Özdemir 0000-0003-2008-163X

Abdulkadir Özgür 0000-0002-6155-5988

Mehmet Celebi 0000-0002-0297-3338

Dursun Mehmet Mehel 0000-0002-5613-3393

Asude Ünal 0000-0003-0282-8277

Gokhan Akgul 0000-0003-0699-6585

Tugba Yemis This is me 0000-0001-8713-0251

Project Number -
Publication Date September 16, 2019
Submission Date May 8, 2019
Published in Issue Year 2019

Cite

AMA Özdemir D, Özgür A, Celebi M, Mehel DM, Ünal A, Akgul G, Yemis T. Fasiyal Paralizili Hastalarda Başvuru Süresi ile Paralizi Derecesi Arasındaki İlişki. Sakarya Tıp Dergisi. September 2019;9(3):544-549. doi:10.31832/smj.562018

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