Race and sex demographics in the surgical management of facial nerve palsy

OBJECTIVE: Facial palsy affects patients of all backgrounds, yet no existing studies describe differences in its treatment patterns between demographic groups. METHODS: We used the National Surgical Quality Improvement Project database to investigate whether race and sex disparities exist in facial reanimation surgery. Patients were identified using CPT codes corresponding to facial‐nerve procedures. RESULTS: Seven hundred sixty‐one patients met criteria; 681 self‐identified as White (89.5%), 51 as Black (6.7%), 43 as Hispanic (5.6%), 23 as Asian (3.0%), and 5 patients as other (0.61%). White patients were more than twice as likely to undergo brow ptosis repair than Non‐White patients (OR 2.49, 95% CI 1.16–6.15, p = .03). After controlling for malignancy, men had longer operative times than women (480.2 vs. 413.9 min, p = .04) and higher likelihood of free tissue transfer (OR 4.1, 95% CI 1.9–9.8), fascial free tissue transfer (OR 10.7, 95% CI 2.1–195), and ectropion repair (OR 1.8, 95% CI 1.2–2.8). CONCLUSION: Most patients undergoing facial reanimation surgery in the United States are White. Men have longer operative times and a higher likelihood of undergoing free fascial grafts and cutaneous and fascial free tissue transfer than women regardless of malignancy status. LEVEL OF EVIDENCE: 2c.