The Impact of Duration of Facial Nerve Palsy on Quality of Life

Introduction: Facial palsy can substantially impact daily functioning and psychosocial well-being. The relationship between duration of facial palsy and quality of life (QoL) remains unclear, with previous studies often assuming a linear association. This study aimed to further explore the association between duration of facial palsy and patient-reported QoL. Methods: We retrospectively analyzed 84 adult patients with facial palsy attending the outpatient clinic of a tertiary plastic surgery center. Facial function was assessed using the Sunnybrook Facial Grading System, and QoL was measured with the disease-specific Facial Clinimetric Evaluation (FaCE) scale. Nested regression models were constructed to evaluate duration of palsy as a linear, quadratic, and cubic term, adjusting for age, gender, and Sunnybrook score. Changes in explained variance ( R 2 ) were used to assess model fit. Results: Median age was 62.6 years, and median duration of palsy was 12.1 years. Vestibular schwannoma (27%) and trauma (11%) were the most common etiologies. The baseline model explained 21.0% of variance in QoL scores. Including duration of palsy as a quadratic term significantly increased explained variance to 28.9% ( R 2 change = .079, P = .025). Linear and cubic functions did not significantly improve model fit. The relationship between duration of palsy and QoL appeared non-linear, with initial improvements followed by long-term decline. Conclusion: Duration of facial palsy is associated with QoL in a non-linear manner. Future studies should consider including duration of palsy, preferably modeled quadratically, when investigating factors influencing QoL.