Facial palsy: treatment, quality of life, and assessment

Part II of this thesis consists of comparative studies of reanimation procedures. Physical therapy seems to have a beneficial effect on the development of a spontaneous smile after smile reanimation. In addition, we found a similar effect of two surgical procedures for long-standing facial palsy.Part III describes the results of two studies on the treatment of synkinesis. We saw that mime therapists can be divided into two groups, but we do not know whether that will affect treatment. Furthermore, we saw that the long-term results of a procedure for synkinesis around the eye diminished over time but was still favorable.In part IV we have attempted to achieve a better estimate of facial palsy-related quality of life and thus increase our understanding of the impact of facial palsy on quality of life. We saw that facial function explained the largest component in quality of life, that movement of the corner of the mouth is the most important component thereof, and that the stated portion of quality of life becomes greater when patient reported severity of synkinesis is included.In part V we have studied aspects of different assessment methods of facial function in patients with facial paralysis. We found a considerable learning curve for these assessments, that 3D measurements are reliable, and have translated a questionnaire. We saw that beauty is more dependent on the person watching than the person being watched. Finally, we developed software that looks at the expression of a patient instead of just the smile