Relationship Between Facial Motor Impairment, Swallowing Function and Oral Motor Dysfunction in Patients with Post-Stroke Central Facial Paralysis.

Background and

Objectives

Central facial paralysis following stroke may affect oral motor control and swallowing function; however, its role in dysphagia-related impairments remains unclear. This study aimed to investigate the relationship between facial motor impairment, swallowing function, and oral motor dysfunction in patients with post-stroke central facial paralysis.

Methods

This cross-sectional observational study included 80 patients with ischemic or hemorrhagic stroke accompanied by central facial paralysis. Facial motor function was evaluated using the Sunnybrook Facial Grading System. Swallowing function was assessed using the Eating Assessment Tool-10 (EAT-10), Repetitive Saliva Swallowing Test (RSST), and Functional Oral Intake Scale (FOIS). Oral motor dysfunction was evaluated using a clinician-based oral motor assessment form. Correlation and exploratory regression analyses were performed.

Results

Significant associations were identified between facial motor function, swallowing measures, and oral motor parameters (all p < 0.001). Sunnybrook scores showed strong negative correlations with EAT-10 scores (r = -0.954) and positive correlations with RSST (r = 0.914) and FOIS scores (r = 0.915). In exploratory regression analyses, NIHSS emerged as an important contributor to swallowing-related outcomes. Labial and tongue functions were independently associated with RSST performance, whereas labial, velar, and buccal functions were independently associated with EAT-10 scores. Velar function was the only oral motor variable independently associated with FOIS levels.

Conclusions

Facial motor function, oral motor dysfunction, and swallowing-related measures were significantly associated in individuals with post-stroke central facial paralysis. Overall, neurological severity also contributed substantially to swallowing-related outcomes. These findings may suggest a potential association between oral motor dysfunction and swallowing-related outcomes and may warrant consideration in comprehensive dysphagia evaluation. However, the observed relationships should be interpreted as exploratory and require confirmation in future studies using validated assessment tools and instrumental swallowing measures.