Published, Version of Record (VoR)CC BY V4.0, Open
Abstract
Rapid Communication
Introduction
Non-flaccid facial paralysis (NFFP) is a distressing sequela of facial nerve injury that greatly impacts facial function and quality of life [1, 2]. Facial synkinesis is a subtype of NFFP that causes involuntary facial contractions during voluntary facial movements (e.g., eye closure during speech) [3]. Aside from its impact on facial movements, facial synkinesis can also lead to social anxiety, depression, and diminished quality of life [2, 4-6]. Various treatments exist for the management of NFFP and range from physical therapy to surgical intervention [3, 6, 7]. Facial neuromuscular retraining is a type of physical therapy that is often utilized by patients to retrain facial muscles and improve overall facial function [8]. The main adjunctive treatment for NFFP is chemodenervation with botulinum toxin, which has been shown to improve both facial function and psychological burden [9, 10].
The social determinants of health (SDoH), including geographic, socioeconomic, and structural barriers, influence health outcomes across many health conditions [11], but their impact on facial paralysis has yet to be determined. The aim of this study is to examine how individual and neighborhood SDoH factors affect NFFP outcomes and access to care.