The Correlation between Peripheral Facial Neuropathy and Oropharyngeal Dysfunction

ABSTRACT

OBJECTIVE: To know the correlation between the grading of facial neuropathy by facial nerve conduction study (FNCS) and dysphagia severity by videofluoroscopic swallowing study (VFSS) in patients with acute peripheral facial palsy (PFP). METHOD: Twenty patients with acute PFP were recruited for this study. The causes of acute PFP were limited to idiopathic Bell's palsy and Ramsay-Hunt syndrome. The time interval from the onset of PFP to study of FNCS and VFSS was 10 to 14 days. The severity of PFP was graded according to House-Brackmann facial nerve grade (H-B FNG). Percent degeneration grade (PDG) was determined by FNCS. Baseline-to-peak amplitude of compound muscle action potentials in orbicularis oris muscle was used as an evaluation parameter. Oral transit time (OTT), pharyngeal transit time (PTT), pharyngeal delay time (PDT) and dysphagia limit were obtained by VFSS. RESULTS: There was a significant correlation between PDG and H-B FNG. The severity of oropharyngeal dysfunction was increased as the severity of the PDG increases. Delayed OTT, delayed PDT, and/or reduced dysphagia limit were revealed as a presentation of oropharyngeal dysfunction in acute PFP. CONCLUSION: The severity of PFP and oropharyngeal dysfunction were significantly correlated. And so we think that precise evaluation and adequate management of oropharyngeal dysfunction will be needed in acute PFP patients.