Facial Clinimetric Evaluation (FaCE) Scale

Original Editor - Arnold Fredrick D'Souza Top Contributors -

Introduction[edit | edit source]

The Facial Clinimetric Evaluation (FaCE) scale was developed by Dr. Jeffrey B. Kahn and colleagues in order to measure both impairment and disability associated with facial dysfunction. It can specifically assess facial function and quality of life after facial paralysis.[1]

Intended Population[edit | edit source]

It can be used in facial paralysis resulting from Bell's palsy and vestibular schwannoma.[1]

Method of Use[edit | edit source]

It is a patient-rated outcome measure with 15 items rated on a 5-point Likert scale. The patient must select the most appropriate response to a given statement, where 1 corresponds to the lowest level of function and 5 corresponds to the highest level of function. The items are categorized into 6 domains: facial movement, facial comfort, oral function, eye comfort, lacrimal control and social function with each domain being scored out of a total of 100 where 0 is the worst possible score to 100 being the best. The mean derived from all domains will determine the total score (out of 100).[1]

A FaCE worksheet can be found here. The score calculation formulae for the domains are described in Appendix B of Kahn et al, 2001.

The FaCE has been translated to Swedish[2], Chinese[3], Dutch[4], French[5], Spanish[6], German[7] and Brazilian Portuguese[8].

Evidence[edit | edit source]

The test-retest reliability of the FaCE scale is high. It exhibited a significant correlation with the House-Brackmann and Sunnybrook Facial Grading System, and the Facial Disability Index. Two geographically different populations exhibited similar results.[1]

A prospective follow-up study comparing patient-reported facial and psychosocial function (FaCE scale and FDI outcome measures) with physician-graded facial function (Sunnybrook and House-Brackmann grading) in early and follow-up stages in Bell’s palsy patients showed low to fair correlation between FaCE/FDI and Sunnybrook score in early stages, suggesting a quality of life (QOL) designs are less suited for the acute stage, and higher correlations at follow-ups suggest using of questionnaires for QoL evaluation with time.[9]

Advantages[edit | edit source]

Unlike the House-Brackmann and Sunnybrook Facial Grading System, the FaCE scale is able to focus more on the disability resulting from facial dysfunction. Additionally, it is easier to administer compared to the real-time direct assessment by qualified professionals mandated by the traditional scales, thus saving on time and overcoming geographical limitations.[1]

References[edit | edit source]

  1. 1.0 1.1 1.2 1.3 1.4 Kahn JB, Gliklich RE, Boyev KP, Stewart MG, Metson RB, McKenna MJ. Validation of a patient‐graded instrument for facial nerve paralysis: the FaCE scale. The Laryngoscope. 2001 Mar;111(3):387-98.
  2. Marsk E, Hammarstedt-Nordenvall L, Engström M, Jonsson L, Hultcrantz M. Validation of a Swedish version of the facial disability index (FDI) and the facial clinimetric evaluation (FaCE) scale. Acta oto-laryngologica. 2013 Jun 1;133(6):662-9.
  3. Li Y, Jiang H, Wang K, Feng GD, Ding XY, Zha Y, Cui TT, Gao ZQ. Quality of life survey on patients with peripheral facial paralysis by using Chinese version of the FaCE scale. Chinese journal of otorhinolaryngology head and neck surgery. 2013 Jan 1;48(1):11-6.
  4. Kleiss IJ, Beurskens CH, Stalmeier PF, Ingels KJ, Marres HA. Quality of life assessment in facial palsy: validation of the Dutch Facial Clinimetric Evaluation Scale. European Archives of Oto-Rhino-Laryngology. 2015 Aug;272(8):2055-61.
  5. Barry P, Mancini J, Alshukry A, Salburgo F, Lavieille JP, Montava M. Validation of french versions of the facial disability index and the facial clinimetric evaluation scale, specific quality of life scales for peripheral facial palsy patients. Clinical Otolaryngology. 2019 May;44(3):313-22.
  6. Garcia-Iza L, Chiesa-Estomba CM, Rosell-Romero N, Ibarguren-Esnal E, Soriano-Reixach M, Rivera-Schmitz T, Altuna X, Gonzalez-García JA. Translation and Validation of the Facial Clinimetric Evaluation Scale to Spanish. Otolaryngology–Head and Neck Surgery. 2020 Nov 10:0194599820969622.
  7. Volk GF, Steigerwald F, Vitek P, Finkensieper M, Kreysa H, Guntinas-Lichius O. Facial Disability Index und Facial Clinimetric Evaluation Skala: Validierung der Deutschen Versionen [Facial Disability Index and Facial Clinimetric Evaluation Scale: validation of the German versions]. Laryngorhinootologie. 2015 Mar;94(3):163-8. German. doi: 10.1055/s-0034-1381999. Epub 2014 Aug 4. PMID: 25089633.
  8. Tavares-Brito J, Fonseca AC, Torres RP, Veen MM, Greene J, Salomone R, Bahmad Jr F, Hadlock T, Bento RF. Facial Clinimetric Evaluation Scale and Synkinesis Assessment Questionnaire Translation into Brazilian Portuguese: A Validation Study. International archives of otorhinolaryngology. 2020 Mar;24(1):e24-30.
  9. Bylund N, Hultcrantz M, Jonsson L, Marsk E. Quality of Life in Bell's Palsy: Correlation with Sunnybrook and House‐Brackmann Over Time. The Laryngoscope. 2021 Feb;131(2):E612-8.