{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T17:15:01Z","timestamp":1793812501253,"version":"4.6.1"},"reference-count":42,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:sec id=\"ab-ooi230012-4\"><jats:title>Importance<\/jats:title><jats:p>The management of vestibular schwannoma may include observation, microsurgical resection, or radiation of a tumor near the facial nerve. Injury to the facial nerve can result in facial paralysis with major functional, social, and psychological sequelae, and the experiences of patients after paralysis are not well studied.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230012-5\"><jats:title>Objective<\/jats:title><jats:p>To (1) identify patient preparedness for developing facial paralysis and how well their care is coordinated following its development and (2) present in their own words outcomes of facial paralysis in terms of physical health, emotional health, self-perception, and social interactions.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230012-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>A qualitative observational study was performed using semistructured interviews at a tertiary care academic medical center. Semistructured interviews were conducted between January 1, 2018, and June 30, 2019, with adults aged 25 to 70 years who developed facial paralysis after treatment for vestibular schwannoma. Data were analyzed from July 2019 to June 2020.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230012-7\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Perceptions of the educational and emotional experiences of individuals who developed complete facial paralysis after surgical treatment of vestibular schwannoma.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230012-8\"><jats:title>Results<\/jats:title><jats:p>Overall, 12 participants were interviewed (median age, 54 years [range, 25-70 years]; 11 were female). Saturation was achieved after 12 interviews, indicating that no further information could be elicited from additional interviews. Four major themes were identified: (1) lack of sufficient patient education about the diagnosis of facial paralysis; (2) lack of appropriate care coordination related to facial paralysis; (3) changes in physical and emotional health following facial paralysis; and (4) changes in social interactions and external support following facial paralysis.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230012-9\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>It is well-known that patients with facial paralysis have reduced quality of life, severe psychological and emotional sequelae. However, little is currently done to help prepare patients for this undesirable outcome. In this qualitative study of facial paralysis, patients express, in their own words, their feeling that the education and management of facial paralysis by their clinicians was inadequate. Before patients undergo surgery, and certainly after injury to the facial nerve, clinicians should consider the patient\u2019s goals, preferences, and values to ensure that a comprehensive educational program and psychosocial support system are implemented. Facial reanimation research has not adequately captured these key patient factors associated with the quality of communication.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaoto.2023.0371","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T16:33:04Z","timestamp":1682008384000},"page":"485","source":"Crossref","is-referenced-by-count":17,"title":["Patient Perception of Education, Care Coordination, and Psychological Distress After Developing Facial Paralysis"],"prefix":"10.1001","volume":"149","author":[{"given":"Natalie R.","family":"Kenton","sequence":"first","affiliation":[{"name":"Center for Outcomes Research and Education, Providence St Joseph Health, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merai","family":"Estafanous","sequence":"additional","affiliation":[{"name":"Loma Linda University School of Medicine, Loma Linda, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyohei","family":"Itamura","sequence":"additional","affiliation":[{"name":"Cedars-Sinai Otolaryngology\u2013Head and Neck Surgery, Beverly Hills, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ania","family":"Filus","sequence":"additional","affiliation":[{"name":"University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanthi","family":"Gowrinathan","sequence":"additional","affiliation":[{"name":"St John\u2019s Cancer Institute, Pacific Neuroscience Institute, Providence St John\u2019s Medical Center, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil A.","family":"Martin","sequence":"additional","affiliation":[{"name":"St John\u2019s Cancer Institute, Pacific Neuroscience Institute, Providence St John\u2019s Medical Center, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walavan","family":"Sivakumar","sequence":"additional","affiliation":[{"name":"St John\u2019s Cancer Institute, Pacific Neuroscience Institute, Providence St John\u2019s Medical Center, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garni","family":"Barkhoudarian","sequence":"additional","affiliation":[{"name":"St John\u2019s Cancer Institute, Pacific Neuroscience Institute, Providence St John\u2019s Medical Center, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J.","family":"Byrne","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Head & Neck Institute, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Kochhar","sequence":"additional","affiliation":[{"name":"St John\u2019s Cancer Institute, Pacific Neuroscience Institute, Providence St John\u2019s Medical Center, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"4","key":"ooi230012r1","first-page":"1","article-title":"Acoustic neuroma.","volume":"9","year":"1991","journal-title":"Consens Statement"},{"issue":"10","key":"ooi230012r2","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1080\/00016480701200210","article-title":"The prevalence and clinical course of patients with \u2018incidental\u2019 acoustic neuromas.","volume":"127","author":"Jeyakumar","year":"2007","journal-title":"Acta Otolaryngol"},{"issue":"5","key":"ooi230012r3","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1016\/j.otohns.2010.01.037","article-title":"Current epidemiology and management trends in acoustic neuroma.","volume":"142","author":"Gal","year":"2010","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"1","key":"ooi230012r4","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1002\/lary.20672","article-title":"Trends in the management of vestibular schwannomas at Johns Hopkins 1997-2007.","volume":"120","author":"Tan","year":"2010","journal-title":"Laryngoscope"},{"issue":"1","key":"ooi230012r5","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1046\/j.1365-2273.2000.00326.x","article-title":"Impairments, disabilities, and handicaps after acoustic neuroma surgery.","volume":"25","author":"Bateman","year":"2000","journal-title":"Clin Otolaryngol Allied Sci"},{"issue":"1","key":"ooi230012r6","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1097\/00005537-200001000-00027","article-title":"Postoperative quality of life in vestibular schwannoma patients measured by the SF36 Health Questionnaire.","volume":"110","author":"da Cruz","year":"2000","journal-title":"Laryngoscope"},{"issue":"6","key":"ooi230012r7","doi-asserted-by":"publisher","first-page":"799","DOI":"10.3171\/jns.1989.71.6.0799","article-title":"Surgery for acoustic neurinoma. 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