Physiotherapy in patients with facial nerve paresis: Description of outcomes

Beurskens, Carien H. G.; Heymans, Peter

doi:10.1016/j.amjoto.2004.04.010

Cited by 56 publications

(52 citation statements)

References 13 publications

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“…[140][141][142][143] Several small studies suggested physical therapy resulted in some level of improvement in patients experiencing prolonged symptoms. 54,[140][141][142][143][144][145][146][147] Unfortunately, the therapeutic impact of physical therapy in these case reviews is impossible to separate from spontaneous recovery. 146 There was no significant difference in any measure of clinical outcome found between the different rehabilitation techniques described in the literature.…”

Section: Supporting Textmentioning

confidence: 99%

“…Several therapy modalities were discussed, including thermal treatment, electrotherapy, massage, facial exercise, and biofeedback, 54,138,139 and most studies combined more than 1 treatment method. [140][141][142][143] Mime therapy, the most common form of physical therapy offered, was defined as including massage, relaxation exercises, inhibition of synkinesis, and emotional expressive exercise. [140][141][142][143] Several small studies suggested physical therapy resulted in some level of improvement in patients experiencing prolonged symptoms.…”

Section: Supporting Textmentioning

confidence: 99%

“…[140][141][142][143] Mime therapy, the most common form of physical therapy offered, was defined as including massage, relaxation exercises, inhibition of synkinesis, and emotional expressive exercise. [140][141][142][143] Several small studies suggested physical therapy resulted in some level of improvement in patients experiencing prolonged symptoms. 54,[140][141][142][143][144][145][146][147] Unfortunately, the therapeutic impact of physical therapy in these case reviews is impossible to separate from spontaneous recovery.…”

Section: Supporting Textmentioning

confidence: 99%

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Clinical Practice Guideline: Bell's Palsy

Baugh

Basura

Ishii

et al. 2013

Otolaryngol.--head neck surg.

377

114

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Objective Bell’s palsy, named after the Scottish anatomist, Sir Charles Bell, is the most common acute mono-neuropathy, or disorder affecting a single nerve, and is the most common diagnosis associated with facial nerve weakness/paralysis. Bell’s palsy is a rapid unilateral facial nerve paresis (weakness) or paralysis (complete loss of movement) of unknown cause. The condition leads to the partial or complete inability to voluntarily move facial muscles on the affected side of the face. Although typically self-limited, the facial paresis/paralysis that occurs in Bell’s palsy may cause significant temporary oral incompetence and an inability to close the eyelid, leading to potential eye injury. Additional long-term poor outcomes do occur and can be devastating to the patient. Treatments are generally designed to improve facial function and facilitate recovery. There are myriad treatment options for Bell’s palsy, and some controversy exists regarding the effectiveness of several of these options, and there are consequent variations in care. In addition, numerous diagnostic tests available are used in the evaluation of patients with Bell’s palsy. Many of these tests are of questionable benefit in Bell’s palsy. Furthermore, while patients with Bell’s palsy enter the health care system with facial paresis/paralysis as a primary complaint, not all patients with facial paresis/paralysis have Bell’s palsy. It is a concern that patients with alternative underlying etiologies may be misdiagnosed or have unnecessary delay in diagnosis. All of these quality concerns provide an important opportunity for improvement in the diagnosis and management of patients with Bell’s palsy. Purpose The primary purpose of this guideline is to improve the accuracy of diagnosis for Bell’s palsy, to improve the quality of care and outcomes for patients with Bell’s palsy, and to decrease harmful variations in the evaluation and management of Bell’s palsy. This guideline addresses these needs by encouraging accurate and efficient diagnosis and treatment and, when applicable, facilitating patient follow-up to address the management of long-term sequelae or evaluation of new or worsening symptoms not indicative of Bell’s palsy. The guideline is intended for all clinicians in any setting who are likely to diagnose and manage patients with Bell’s palsy. The target population is inclusive of both adults and children presenting with Bell’s palsy. Action Statements The development group made a strong recommendation that (a) clinicians should assess the patient using history and physical examination to exclude identifiable causes of facial paresis or paralysis in patients presenting with acute-onset unilateral facial paresis or paralysis, (b) clinicians should prescribe oral steroids within 72 hours of symptom onset for Bell’s palsy patients 16 years and older, (c) clinicians should not prescribe oral antiviral therapy alone for patients with new-onset Bell’s palsy, and (d) clinicians should implement eye protection for Bell’s palsy patients with impaired eye closure. The panel made recommendations that (a) clinicians should not obtain routine laboratory testing in patients with new-onset Bell’s palsy, (b) clinicians should not routinely perform diagnostic imaging for patients with new-onset Bell’s palsy, (c) clinicians should not perform electrodiagnostic testing in Bell’s palsy patients with incomplete facial paralysis, and (d) clinicians should reassess or refer to a facial nerve specialist those Bell’s palsy patients with (1) new or worsening neurologic findings at any point, (2) ocular symptoms developing at any point, or (3) incomplete facial recovery 3 months after initial symptom onset. The development group provided the following options: (a) clinicians may offer oral antiviral therapy in addition to oral steroids within 72 hours of symptom onset for patients with Bell’s palsy, and (b) clinicians may offer electrodiagnostic testing to Bell’s palsy patients with complete facial paralysis. The development group offered the following no recommendations: (a) no recommendation can be made regarding surgical decompression for patients with Bell’s palsy, (b) no recommendation can be made regarding the effect of acupuncture in patients with Bell’s palsy, and (c) no recommendation can be made regarding the effect of physical therapy in patients with Bell’s palsy.

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Section: Supporting Textmentioning

confidence: 99%

Section: Supporting Textmentioning

confidence: 99%

Section: Supporting Textmentioning

confidence: 99%

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Clinical Practice Guideline: Bell's Palsy

Baugh

Basura

Ishii

et al. 2013

Otolaryngol.--head neck surg.

377

114

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“…Results show an improvement in facial symmetry and in syncinesis in 24 patients. Neuromuscular training for facial movement exercises are used in order to improve facial symmetry 9,4 . The main physical therapy resources employed in the patients of the present study were: kinesiotherapy, massotherapy, cryotherapy and electrotherapy.…”

mentioning

confidence: 99%

“…Nonetheless, electrotherapy may be responsible for an increase in tetany and hypertonia that cause syncinesis. This treatment modality has been abandoned in favor of analytical muscular work and muscle stretching exercieses [9][10][11][12][13][14] . All the patients in the present study were instructed as to the care they should take in domestic activities.…”

mentioning

confidence: 99%

Fisioterapia na paralisia facial periférica: estudo retrospectivo

Garanhani

Cardoso

Capelli

et al. 2007

Rev. Bras. Otorrinolaringol.

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Peri pheral facial paralysis requires specialized treatment.Physical therapy aims at reestablishing facial movements. The aim of this study was to describe and to analyze physical therapy results for individuals with peripheral facial paralysis. Study design: Retrospective study. Method: A retrospective study was carried out at the University Hospital, authorized by the Statistics and Medical File Services, from 1999 to 2003. Data are presented in descriptive form with mean and median values for numeric variables and frequency for categorical variables. Results: Twenty-three files were analyzed during four years. Females predominated and the average age was of 32.3 years (SD±16.5); 14 idiopathic and five trauma cases; 12 with total motor deficit and 11 with partial motor deficit; in the 12 cases that underwent final evaluation, seven had partial and five had total recovery. The physical therapy program used was kinesiotherapy and patient education. Conclusion: In this study, individuals were similar to individuals in other populations. They were treated with kinesiotherapy, as suggested by the scientific literature and recovered.

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Macroscopic In Vivo Imaging of Facial Nerve Regeneration in Thy1-GFP Rats

Placheta

Wood

Lafontaine

et al. 2015

JAMA Facial Plast Surg

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IMPORTANCE Facial nerve injury leads to severe functional and aesthetic deficits. The transgenic Thy1-GFP rat is a new model for facial nerve injury and reconstruction research that will help improve clinical outcomes through translational facial nerve injury research. OBJECTIVE To determine whether serial in vivo imaging of nerve regeneration in the transgenic rat model is possible, facial nerve regeneration was imaged under the main paradigms of facial nerve injury and reconstruction. DESIGN, SETTING, AND PARTICIPANTS Fifteen male Thy1-GFP rats, which express green fluorescent protein (GFP) in their neural structures, were divided into 3 groups in the laboratory: crush-injury, direct repair, and cross-face nerve grafting (30-mm graft length). The distal nerve stump or nerve graft was predegenerated for 2 weeks. The facial nerve of the transgenic rats was serially imaged at the time of operation and after 2, 4, and 8 weeks of regeneration. The imaging was performed under a GFP-MDS-96/BN excitation stand (BLS Ltd). INTERVENTION OR EXPOSURE Facial nerve injury. MAIN OUTCOME AND MEASURE Optical fluorescence of regenerating facial nerve axons. RESULTS Serial in vivo imaging of the regeneration of GFP-positive axons in the Thy1-GFP rat model is possible. All animals survived the short imaging procedures well, and nerve regeneration was followed over clinically relevant distances. The predegeneration of the distal nerve stump or the cross-face nerve graft was, however, necessary to image the regeneration front at early time points. Crush injury was not suitable to sufficiently predegenerate the nerve (and to allow for degradation of the GFP through Wallerian degeneration). After direct repair, axons regenerated over the coaptation site in between 2 and 4 weeks. The GFP-positive nerve fibers reached the distal end of the 30-mm-long cross-face nervegrafts after 4 to 8 weeks of regeneration. CONCLUSIONS AND RELEVANCE The time course of facial nerve regeneration was studied by serial in vivo imaging in the transgenic rat model. Nerve regeneration was followed over clinically relevant distances in a small number of experimental animals, as they were subsequently imaged at multiple time points. The Thy1-GFP rat model will help improve clinical outcomes of facial reanimation surgery through improving the knowledge of facial nerve regeneration after surgical procedures. LEVEL OF EVIDENCE NA.

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Physiotherapy in patients with facial nerve paresis: Description of outcomes

Cited by 56 publications

References 13 publications

Clinical Practice Guideline: Bell's Palsy

Clinical Practice Guideline: Bell's Palsy

Fisioterapia na paralisia facial periférica: estudo retrospectivo

Macroscopic In Vivo Imaging of Facial Nerve Regeneration in Thy1-GFP Rats

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