Factors affecting the effect of physical rehabilitation therapy for synkinesis as a sequela to facial nerve palsy

Auris Nasus Larynx. 2018 Aug;45(4):732-739. doi: 10.1016/j.anl.2017.10.003.

Abstract

Objective: To investigate factors affecting the effect of physical rehabilitation therapy for synkinesis as a sequela to facial nerve palsy.

Methods: A total of 37 patients with peripheral facial nerve palsy in Teine-Keijinkai Hospital were enrolled in this study. All patients showed synkinesis at 6 months after the onset of facial nerve palsy and were instructed in physical rehabilitation by expert staff from their first visit. The degree of synkinesis was evaluated at 6, 9 and 12 months after the onset of facial nerve palsy based on Sunnybrook facial grading system score and asymmetry in eye opening width. The patients were divided into two groups by age, gender, cause of palsy, electroneurography (ENoG) value, onset of synkinesis, initial treatment and timing of the start of physical rehabilitation.

Results: Female patients and younger patients did not show any deterioration in synkinesis. Patients in the lower ENoG group and the later onset of synkinesis group showed significant deterioration in synkinesis after the 6th month from onset of facial palsy.

Conclusion: Physical rehabilitation was shown to prevent significant deterioration in synkinesis in female and younger patients with facial nerve palsy. Careful follow-up with regard to synkinesis is required in cases in which the facial nerve damage is thought to be severe.

Keywords: Biofeedback; Facial nerve palsy; Physical rehabilitation; Sunnybrook facial grading system; Synkinesis.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Antiviral Agents / therapeutic use
  • Bell Palsy / complications
  • Bell Palsy / drug therapy
  • Bell Palsy / physiopathology
  • Bell Palsy / rehabilitation*
  • Facial Nerve Diseases / complications
  • Facial Nerve Diseases / drug therapy
  • Facial Nerve Diseases / physiopathology
  • Facial Nerve Diseases / rehabilitation
  • Facial Paralysis / complications
  • Facial Paralysis / drug therapy
  • Facial Paralysis / physiopathology
  • Facial Paralysis / rehabilitation*
  • Female
  • Glucocorticoids / therapeutic use
  • Herpes Zoster Oticus / complications
  • Herpes Zoster Oticus / drug therapy
  • Herpes Zoster Oticus / physiopathology
  • Herpes Zoster Oticus / rehabilitation*
  • Humans
  • Male
  • Middle Aged
  • Neural Conduction
  • Physical Therapy Modalities*
  • Prednisolone / therapeutic use
  • Sex Factors
  • Synkinesis / etiology
  • Synkinesis / physiopathology
  • Synkinesis / rehabilitation*

Substances

  • Antiviral Agents
  • Glucocorticoids
  • Prednisolone