Rehabilitation of Facial Nerve Palsy

Deniz PALAMARa
aİstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Physical Medicine and Rehabilitation, İstanbul, Türkiye

Palamar D. Rehabilitation of facial nerve palsy. In: Sanus GZ, Batıoğlu Karaaltın A, eds. Surgical Management of Facial Nerve Paralysis. 1st ed. Ankara: Türkiye Klinikleri; 2022. p.250-5.

Article Language: EN

ABSTRACT
Facial nerve palsy results in facial asymmetry and lack of facial expressions, as well as functional limitations, therefore frequently affects the individual’s quality of life. Clinically efficacious treatment approaches are required to prevent the development of synkinesis and to ensure normal symmetrical facial movements. Reliable and reproducible assessment of facial function is essential for monitoring the patient’s progress over time and for the treatment of synkinesis. Neuromuscular reeducation can improve the voluntary functions of the facial muscles and decrease synkinesis. The therapy should best be initiated with EMG biofeedback training and then consist of exercises with mirrors and going on with home exercise program. In facial palsy, neuromuscular electrical stimulation commonly produces ”mass action,” a generalized contraction of many of the facial muscles and may reinforce synkinetic patterns. Botulinum toxin injection can be used to eliminate inappropriate facial movements caused by synkinesis and also for asymmetry. Given the long recovery period of facial paralysis and synkinesis, long-term adherence to home exercise programs should be emphasized.

Keywords: Rehabilitation; facial nerve injuries; synkinesis; exercise therapy

Referanslar

  1. Coulson SE, o'dwyer Nj, Adams RD, Croxson GR. Expression of emotion and quality of life after facial nerve paralysis. otol Neurotol. 2004;25(6):1014-9. [Crossref]  [PubMed]
  2. Kleiss Ij, Hohman MH, Susarla SM, Marres HA, Hadlock TA. Health-related quality of life in 794 patients with a peripheral facial palsy using the FaCE Scale: a retrospective cohort study. Clin otolaryngol. 2015;40(6):651-6. [Crossref]  [PubMed]
  3. Peitersen E. Bell's palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta otolaryngol Suppl. 2002;(549):4-30. [Crossref]
  4. Glass GE, Tzafetta K. Bell's palsy: a summary of current evidence and referral algorithm. Fam Pract. 2014;31(6):631-42. [Crossref]  [PubMed]
  5. Mehta RP, WernickRobinson M, Hadlock TA. validation of the synkinesis assessment questionnaire. Laryngoscope. 2007;117(5):923-6. [Crossref]  [PubMed]
  6. Schaitkin BM. Synkinesis and hyperkinesis. In: Slattery III WH, Azizzadeh B, eds. The Facial Nerve. 1st ed. New York, NY: Thieme Medical Publisher Inc; 2014. p. 213-5.
  7. Burres S, Fisch U. The comparison of facial grading systems. Arch otolaryngol Head Neck Surg. 1986;112(7):755-8. [Crossref]  [PubMed]
  8. House jW. Facial nerve grading systems. Laryngoscope. 1983;93(8):1056-69. [Crossref]  [PubMed]
  9. House jW, Brackmann DE. Facial nerve grading system. otolaryngol Head Neck Surg. 1985;93(2):146-7. [Crossref]  [PubMed]
  10. Ross BG, Fradet G, Nedzelski jM. Development of a sensitive clinical facial grading system. otolaryngol Head Neck Surg. 1996;114(3):380-6. [Crossref]
  11. Neely jG, Cheung jY, Wood M, Byers j, Rogerson A. Computerized quantitative dynamic analysis of facial motion in the paralyzed and synkinetic face. Am j otol. 1992;13(2):97-107.
  12. Neely jG, joaquin AH, Kohn LA, Cheung jY. Quantitative assessment of the variation within grades of facial paralysis. Laryngoscope. 1996;106(4):438-42. [Crossref]  [PubMed]
  13. Fattah AY, Gurusinghe ADR, Gavilan j, Hadlock TA, Marcus jR, Marres H, et al; Sir Charles Bell Society. Facial nerve grading instruments: systematic review of the literature and suggestion for uniformity. Plast Reconstr Surg. 2015;135(2):569-79. [Crossref]  [PubMed]
  14. Chee GH, Nedzelski jM. Facial nerve grading systems. Facial Plast Surg. 2000;16(4):315-24. [Crossref]  [PubMed]
  15. Kayhan FT, Zurakowski D, Rauch SD. Toronto Facial Grading System: interobserver reliability. otolaryngol Head Neck Surg. 2000;122(2):212- 5. [Crossref]  [PubMed]
  16. Banks CA, jowett N, Azizzadeh B, Beurskens C, Bhama P, Borschel G, et al. Worldwide testing of the eFACE facial nerve clinician-graded scale. Plast Reconstr Surg. 2017;139(2):491e-498e. [Crossref]  [PubMed]
  17. 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. Laryngoscope. 2001;111(3):387-98. [Crossref]  [PubMed]
  18. vanSwearingen jM, Brach jS. The Facial Disability Index: reliability and validity of a disability assessment instrument for disorders of the facial neuromuscular system. Phys Ther. 1996;76(12):1288-98; discussion 1298-300. [Crossref]  [PubMed]
  19. Teixeira Lj, valbuza jS, Prado GF. Physical therapy for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2011;(12):CD006283. [Crossref]  [PubMed]
  20. Hadlock T, Cheney ML. Facial reanimation: an invited review and commentary. Arch Facial Plast Surg. 2008;10(6):413-7. [Crossref]  [PubMed]
  21. Balliet R, Shinn jB, Bach-y-Rita P. Facial paralysis rehabilitation: retraining selective muscle control. Int Rehabil Med. 1982;4(2):67-74. [Crossref]  [PubMed]
  22. Lindsay RW, Robinson M, Hadlock TA. Comprehensive facial rehabilitation improves function in people with facial paralysis: a 5-year experience at the Massachusetts Eye and Ear Infirmary. Phys Ther. 2010;90(3):391-7. [Crossref]  [PubMed]
  23. Nicastri M, Mancini P, De Seta D, Bertoli G, Prosperini L, Toni D, et al. Efficacy of early physical therapy in severe Bell's palsy: a randomized controlled trial. Neurorehabil Neural Repair. 2013;27(6):542-51. [Crossref]  [PubMed]
  24. Watson Gj, Glover S, Allen S, Irving RM. outcome of facial physiotherapy in patients with prolonged idiopathic facial palsy. j Laryngol otol. 2015;129(4):348-52. [Crossref]  [PubMed]
  25. Balliet R. Facial paralysis and other neuromuscular dysfunctions of the peripheral nervous system. In: Payton oD, ed. Manual of Physical Therapy. 1st ed. New York: Churchill Livingstone; 1989. p.175-213.
  26. Beurskens CH, Heymans PG. Positive effects of mime therapy on sequelae of facial paralysis: stiffness, lip mobility, and social and physical aspects of facial disability. otol Neurotol. 2003;24(4):677-81. [Crossref]  [PubMed]
  27. Lockhart P, Holland Nj, Swan I, Teixeira Lj. Interventions for Bell's Palsy (idiopathic facial paralysis). Cochrane Database of Systematic Reviews. 2011;(2):CD008974. [Crossref]
  28. Diels Hj. New Concepts in Nonsurgical Facial Nerve Rehabilitation. In: Myers E, Bluestone C, eds. Advances in otolaryngology-Head and Neck Surgery. vol 9. Chicago: Mosby-Year Book; 1995. p.289-315.
  29. vanSwearingen jM, Brach jS. Changes in facial movement and synkinesis with facial neuromuscular reeducation. Plast Reconstr Surg. 2003;111(7):2370-5. [Crossref]  [PubMed]
  30. Diels Hj, Beurskens C. Neuromuscular retraining: nonsurgical therapy for facial nerve palsy. In: Slattery III WH, Azizzadeh B, eds. The Facial Nerve. 1st ed. New York, NY: Thieme; 2014. p.205-12.
  31. Brudny j. Biofeedback in facial paralysis: electromyographic rehabilitation. In: Rubin L, eds. The Paralyzed Face. 1st ed. St Louis, Mo: MosbyYear Book; 1991. p.247-64.
  32. vanSwearingen jM, Brach jS. validation of a treatment-based classification system for individuals with facial neuromotor disorders. Phys Ther. 1998;78(7):678-89. [Crossref]  [PubMed]
  33. Robinson MW, Baiungo j. Facial rehabilitation: evaluation and treatment strategies for the patient with facial Palsy. otolaryngol Clin North Am. 2018;51(6):1151-67. [Crossref]  [PubMed]
  34. vanswearingen j. Facial rehabilitation: a neuromuscular reeducation, patient-centered approach. Facial Plast Surg. 2008;24(2):250-9. [Crossref]  [PubMed]
  35. Wernick Robinson M, Baiungo j, Hohman M, Hadlock T. Facial rehabilitation. oper Tech otolaryngol - Head Neck Surg 2012;23(4):288-96. [Crossref]
  36. Pourmomeny AA, Zadmehre H, Mirshamsi M, Mahmodi Z. Prevention of synkinesis by biofeedback therapy: a randomized clinical trial. otol Neurotol. 2014;35(4):739-42. [Crossref]  [PubMed]
  37. Nakamura K, Toda N, Sakamaki K, Kashima K, Takeda N. Biofeedback rehabilitation for prevention of synkinesis after facial palsy. otolaryngol Head Neck Surg. 2003;128(4):539-43. [Crossref]
  38. Ross B, Nedzelski jM, McLean jA. Efficacy of feedback training in longstanding facial nerve paresis. Laryngoscope. 1991;101(7 Pt 1):744-50. [Crossref]  [PubMed]
  39. Brach jS, vanSwearingen jM, Lenert j, johnson PC. Facial neuromuscular retraining for oral synkinesis. Plast Reconstr Surg. 1997;99(7):1922-31; discussion 1932-3. [Crossref]  [PubMed]
  40. Brach jS, vanSwearingen jM. Physical therapy for facial paralysis: a tailored treatment approach. Phys Ther. 1999;79(4):397-404. [Crossref]  [PubMed]
  41. Brown DM, Nahai F, Wolf S, Basmajian jv. Electromyographic biofeedback in the reeducation of facial palsy. Am j Phys Med. 1978;57(4):183- 90.
  42. Cronin GW, Steenerson RL. The effectiveness of neuromuscular facial retraining combined with electromyography in facial paralysis rehabilitation. otolaryngol Head Neck Surg. 2003;128(4):534-8. [Crossref]
  43. Diels Hj. Facial paralysis: is there a role for a therapist? Facial Plast Surg. 2000;16(4):361-4. [Crossref]  [PubMed]
  44. Fargher KA, Coulson SE. Effectiveness of electrical stimulation for rehabilitation of facial nerve paralysis. Phys Ther Rev 2017;22(3-4):169-76. [Crossref]
  45. Girlanda P, Dattola R, vita G, oteri G, Lo Presti F, Messina C. Effect of electrotherapy on denervated muscles in rabbits: an electrophysiological and morphological study. Exp Neurol. 1982;77(3):483-91. [Crossref]  [PubMed]
  46. Brown MC, Holland RL. A central role for denervated tissues in causing nerve sprouting. Nature. 1979;282(5740):724-6. [Crossref]  [PubMed]
  47. Borodic G, Bartley M, Slattery W, Glasscock M, johnson E, Malazio C, et al. Botulinum toxin for aberrant facial nerve regeneration: double-blind, placebo-controlled trial using subjective endpoints. Plast Reconstr Surg. 2005;116(1):36-43. [Crossref]  [PubMed]
  48. Husseman j, Mehta RP. Management of synkinesis. Facial Plast Surg. 2008;24(2):242-9. [Crossref]  [PubMed]
  49. Filipo R, Spahiu I, Covelli E, Nicastri M, Bertoli GA. Botulinum toxin in the treatment of facial synkinesis and hyperkinesis. Laryngoscope. 2012;122(2):266-70. [Crossref]  [PubMed]
  50. Cabin jA, Massry GG, Azizzadeh B. Botulinum toxin in the management of facial paralysis. Curr opin otolaryngol Head Neck Surg. 2015;23(4):272-80. [Crossref]  [PubMed]
  51. Mehdizadeh oB, Diels j, White WM. Botulinum toxin in the treatment of facial paralysis. Facial Plast Surg Clin North Am. 2016;24(1):11-20. [Crossref]  [PubMed]
  52. de Maio M, Bento RF. Botulinum toxin in facial palsy: an effective treatment for contralateral hyperkinesis. Plast Reconstr Surg. 2007;120(4):917-27. [Crossref]  [PubMed]
  53. Cooper L, Lui M, Nduka C. Botulinum toxin treatment for facial palsy: A systematic review. j Plast Reconstr Aesthet Surg. 2017;70(6):833-841. [Crossref]  [PubMed]