Facial disability index (FDI): adaptation to Spanish, reliability and validity

Objectives: To adapt to Spanish the facial disability index (FDI) described by VanSwearingen and Brach in 1995 and to assess its reliability and validity in patients with facial nerve paresis after parotidectomy. Study Design: The present study was conducted in two different stages: a) cross-cultural adaptation of the questionnaire and b) cross-sectional study of a control group of 79 Spanish-speaking patients who suffered facial paresis after superficial parotidectomy with facial nerve preservation. The cross-cultural adaptation process comprised the following stages: (I) initial translation, (II) synthesis of the translated document, (III) retro-translation, (IV) review by a board of experts, (V) pilot study of the pre-final draft and (VI) analysis of the pilot study and final draft. Results: The reliability and internal consistency of every one of the rating scales included in the FDI (Cronbach's alpha coefficient) was 0.83 for the complete scale and 0.77 and 0.82 for the physical and the social well-being subscales. The analysis of the factorial validity of the main components of the adapted FDI yielded similar results to the original questionnaire. Bivariate correlations between FDI and House-Brackmann scale were positive. The variance percentage was calculated for all FDI components. Conclusions: The FDI questionnaire is a specific instrument for assessing facial neuromuscular dysfunction which becomes a useful tool in order to determine quality of life in patients with facial nerve paralysis. Spanish adapted FDI is equivalent to the original questionnaire and shows similar reliability and validity. The proven reproducibi- lity, reliability and validity of this questionnaire make it a useful additional tool for evaluating the impact of facial nerve paralysis in Spanish-speaking patients

Complications after superficial parotidectomy for pleomorphic adenoma

The significance of complications after superficial parotidectomy remains unclear, since prospective studies are lacking. The aim of this study was to evaluate facial nerve dysfunction and other postoperative complications after superficial parotidectomy for pleomorphic adenoma of the superficial lobe and to identify the associated risk factors. Prospective and descriptive clinical study on 79 patients undergoing formal superficial parotidectomy with the modified facelift incision, dissection of the facial nerve and reconstruction with the superficial musculoaponeurotic system flap. Function of the facial nerve using the House-Brackmann scale and the intra- and postoperative complications were recorded at 1 week and 1, 3, 6 and 12 months. A descriptive, inferential and binary logistic regression analysis were performed for the variables facial nerve dysfunction, tumor size and location, clinical presentation and duration of surgery. 77.2% of the patients presented facial paresis at 1 week, with the marginal-mandibular branch being the most commonly affected (64.5%). 94.9% recovered the facial function at 6 months and 100% at 12 months. A statistically significant relationship was found between the appearance of facial paresis and tumor location in the superior lateral area of the superficial lobe, size >2 cm and prolonged operative time. None of the remaining variables showed significant differences at any study timepoint. At 12 months, 57% of patients had recovered tactile sensitivity in the earlobe. The clinical occurrence of Frey?s syndrome was 11.4%. Despite the high incidence of postoperative facial paresis at 1 week, its magnitude was low and the recovery time was short. Tumor location in the parotid superficial lobe upper area, size and prolonged operative time are risk factors that can worsen facial paresis at different study timepoints. The knowledge of these complications is relevant for patient´s counseling and to achieve better long-term outcomes

Estudio de la parálisis del Nervio Facial en la Cirugía del Adenoma Pleomorfo de la Glándula Parótida Adaptación y validación del índice de discapacidad facial

OBJETIVOS ... MATERIAL Y MÉTODOS El estudio de adaptación y validación del IDF se realizó en dos fases: a) adaptación transcultural de un cuestionario, y b) estudio transversal con grupo control con 79 pacientes con paresia facial tras parotidectomía superficial conservadora y de habla castellana. El proceso de adaptación transcultural constó de las siguientes etapas: (I) traducción inicial, (II) síntesis de la traducción, (III) retro-traducción, (IV) revisión por el comité de expertos, (V) estudio piloto de la versión pre-final y (VI) análisis del estudio piloto y versión final. Para el estudio de validación se analizó la validez del cuestionario mediante el análisis factorial de los componentes principales, la fiabilidad se expresó como consistencia calculándose los coeficientes alfa de Cronbach. Para medir la validez de constructo del cuestionario traducido, se halló la relación existente entre los resultados del IDF y la escala clínica House-Brackmann. Se ha realizado un estudio prospectivo de casos incidentes de tumores parotídeos benignos durante los años 2008-2010. Se han incluido 79 pacientes a los que se realizó una parotidectomía superficial conservadora con diagnóstico de adenoma pleomorfo situados en la porción suprafacial de la glándula parótida. Hemos seguido a los pacientes postquirúrgicamente con revisiones a la semana, 1er mes, 3er mes, 6º mes y 1er año. Se han analizado datos sobre la edad, sexo, modo de presentación y localización de la tumoración, tiempo de proceso diagnóstico, antecedentes personales y familiares, tiempo quirúrgico, levantamiento de colgajo de SMAS, preservación de nervios auricular mayor, tiempo de ingreso, función postoperatoria del nervio facial (medida con escala House-Brackmann y la determinación neurofisiol

Quality of life in early age Spanish children treated for cleft lip and/or palate: a case-control study approach

[Objective] The objectives of this study were to evaluate health-related quality of life (HRQoL) in 4–7-year-old children treated for cleft lip and/or palate (CL/P) compared to healthy controls and to estimate a possible association with cleft type, gender, age, and surgical re-interventions.[Materials and methods] A total of 171 children with CL/P (mean age 5.7 years) and 186 healthy controls (mean age 5.5 years) were included in the study. Sixty-four (37.4%) children experienced both cleft lip and palate, 56 (32.8%) cleft lip only, and 51 (29.8%) cleft palate only. HRQoL in children was assessed by Kiddy-KINDL and COHIP-14 questionnaires and in parents by KINDL-p. Total score and dimensions of each questionnaire were compared between cleft children, their parents, and controls.[Results] The total scores and dimension scores of Kiddy-KINDL showed similar values between CL/P and control groups, except for “self-esteem” dimension (p = 0.036). The comparison of Kiddy-KINDL and KINDL-p showed a statistically significant total score (82.11 vs. 80.44, p = 0.047). The CL/P group presented significantly worse values with respect to controls in total score of COHIP-14 (10.53 vs 5.01, p < 0.001) and in all its dimensions.[Conclusions] Children treated for CL/P had a negative impact on HRQoL at early age compared to controls. Significant differences were found in the psychological and functional dimensions related to lip and palatal affectation, respectively. Parents reported significantly worse scores than their children. HRQoL measurement provided valuable complementary information to better inform to parents and make clinical decisions in children with CL/P at early age.[Clinical relevance] Our findings suggested that Spanish children between 4 and 7 years of age with a history of surgically treated CL/P experienced a poorer HRQoL when compared with their non-cleft peers