The Price of Paralysis: Cost Analysis of Facial Rehabilitation After Vestibular Schwannoma Resection
Facial dysfunction after surgery for vestibular schwannoma is a source of morbidity for patients, but the cost of facial rehabilitation has not been well defined. To help quantify costs, researchers in the Department of Otorhinolaryngology at McGovern Medical School at UTHealth Houston and in the Department of Otolaryngology at The Ohio State University College of Medicine conducted a retrospective cohort study of patients treated at a tertiary referral center between September 2016 and May 2021. They presented their results at the 2024 American Academy of Otolaryngology-Head and Neck Surgery meeting held in Miami.
“We identified 15 patients whose facial dysfunction was managed postoperatively, 67% of whom were women with a median age of 56 at the time of surgery,” says Vivian Kaul, MD, a neurotologist and assistant professor at McGovern Medical School. “During postsurgical management, 11 patients underwent periocular procedures, four patients opted for extensive rehabilitative surgeries, five patients had Botox® therapy, and eight underwent facial retraining therapy. The median cost of these treatments was $3,125.”
After reviewing the data, the researchers concluded that the cost of facial rehabilitation is reasonable regardless of the degree of facial dysfunction. “Despite this, some patients chose not to pursue rehabilitation,” Dr. Kaul says. “We counsel all our patients. At the end of the day, the decision of whether to go through rehabilitation is a joint patient-physician decision.”