Facial Plast Surg
DOI: 10.1055/a-2285-6557
Original Research

Characterizing the Impact of Facial Rehabilitation on Acute Facial Paralysis

Audrey Abend
1   Department of Otolaryngology–Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey
2   Department of Otolaryngology–Head and Neck Surgery, New York University Grossman School of Medicine, New York, New York
,
Lauren Perillo
3   Department of Physical Therapy at Rusk Rehabilitation, NYU Langone Medical Center, New York, New York
,
Jenna DeSimone
3   Department of Physical Therapy at Rusk Rehabilitation, NYU Langone Medical Center, New York, New York
,
Danielle F. Eytan
2   Department of Otolaryngology–Head and Neck Surgery, New York University Grossman School of Medicine, New York, New York
› Author Affiliations

Abstract

Objective Evidence on facial rehabilitation therapy (FRT) for acute facial paralysis (FP) remains limited. We present a retrospective review of patients with acute FP who have received FRT with physical therapists within 1 year of FP onset as determined by Sunnybrook Facial Grading Scale (SFGS) composite scores.

Methods A total of 702 patients with a clinical diagnosis of FP were referred to a university rehabilitation program between January 1, 2015 and January 1, 2022. Seventy-six patients met the criteria, defined as FP diagnosis <12 months before FRT initiation, ≥3 therapy sessions, and sufficient follow-up data.

Results Average number of treatment sessions between SFGS scores was 7.7. History of cancer, sex, number of treatment sessions, and initial SFGS score were correlated with change in SFGS. Time to treatment was not correlated with change in SFGS score. SFGS improved with each additional treatment session (p < 0.01). Each additional point in the initial SFGS was correlated with less change in the final SFGS score (p < 0.01).

Conclusions and Relevance FRT can provide meaningful improvement in functionality for patients with acute FP, regardless of time to treatment. Furthermore, patients who present with poorer functionality at baseline and those who undergo more treatment are most likely to see SFGS improvement. Research comparing the effect of facial rehabilitation with other treatment modalities and to a control cohort is warranted.



Publication History

Accepted Manuscript online:
12 March 2024

Article published online:
08 April 2024

© 2024. Thieme. All rights reserved.

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333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Kim SJ, Lee HY. Acute peripheral facial palsy: recent guidelines and a systematic review of the literature. J Korean Med Sci 2020; 35 (30) e245
  • 2 De Diego-Sastre JI, Prim-Espada MP, Fernández-García F. [The epidemiology of Bell's palsy]. Rev Neurol 2005; 41 (05) 287-290
  • 3 Tavares-Brito J, van Veen MM, Dusseldorp JR, Bahmad Jr F, Hadlock TA. Facial palsy-specific quality of life in 920 patients: correlation with clinician-graded severity and predicting factors. Laryngoscope 2019; 129 (01) 100-104
  • 4 Glicenstein J. [The history of facial paralysis]. Ann Chir Plast Esthet 2015; 60 (05) 347-362
  • 5 House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg 1985; 93 (02) 146-147
  • 6 Fattah AY, Gurusinghe ADR, Gavilan J. et al; Sir Charles Bell Society. Facial nerve grading instruments: systematic review of the literature and suggestion for uniformity. Plast Reconstr Surg 2015; 135 (02) 569-579
  • 7 Kanerva M, Poussa T, Pitkäranta A. Sunnybrook and House-Brackmann facial grading systems: intrarater repeatability and interrater agreement. Otolaryngol Head Neck Surg 2006; 135 (06) 865-871
  • 8 Cabrol C, Elarouti L, Montava AL. et al. Sunnybrook facial grading system: intra-rater and inter-rater variabilities. Otol Neurotol 2021; 42 (07) 1089-1094
  • 9 Finsterer J. Management of peripheral facial nerve palsy. Eur Arch Otorhinolaryngol 2008; 265 (07) 743-752
  • 10 Robinson MW, Baiungo J. Facial rehabilitation: evaluation and treatment strategies for the patient with facial palsy. Otolaryngol Clin North Am 2018; 51 (06) 1151-1167
  • 11 Baugh RF, Basura GJ, Ishii LE. et al. Clinical practice guideline: Bell's palsy. Otolaryngol Head Neck Surg 2013; 149 (3 Suppl): S1-S27
  • 12 Sullivan FM, Swan IR, Donnan PT. et al. Early treatment with prednisolone or acyclovir in Bell's palsy. N Engl J Med 2007; 357 (16) 1598-1607
  • 13 Karp E, Waselchuk E, Landis C, Fahnhorst J, Lindgren B, Lyford-Pike S. Facial rehabilitation as noninvasive treatment for chronic facial nerve paralysis. Otol Neurotol 2019; 40 (02) 241-245
  • 14 Agostini F, Mangone M, Santilli V. et al. Idiopathic facial palsy: umbrella review of systematic reviews and meta-analyses. J Biol Regul Homeost Agents 2020; 34 (04) 1245-1255
  • 15 Teixeira LJ, Valbuza JS, Prado GF. Physical therapy for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev 2011; 1 (12) CD006283
  • 16 Wamkpah NS, Jeanpierre L, Lieu JEC, Del Toro D, Simon LE, Chi JJ. Physical therapy for iatrogenic facial paralysis: a systematic review. JAMA Otolaryngol Head Neck Surg 2020; 146 (11) 1065-1072
  • 17 Pereira LM, Obara K, Dias JM, Menacho MO, Lavado EL, Cardoso JR. Facial exercise therapy for facial palsy: systematic review and meta-analysis. Clin Rehabil 2011; 25 (07) 649-658
  • 18 Manikandan N. Effect of facial neuromuscular re-education on facial symmetry in patients with Bell's palsy: a randomized controlled trial. Clin Rehabil 2007; 21 (04) 338-343
  • 19 Nicastri M, Mancini P, De Seta D. et al. Efficacy of early physical therapy in severe Bell's palsy: a randomized controlled trial. Neurorehabil Neural Repair 2013; 27 (06) 542-551
  • 20 Fujiwara K, Furuta Y, Yamamoto N, Katoh K, Fukuda S. Factors affecting the effect of physical rehabilitation therapy for synkinesis as a sequela to facial nerve palsy. Auris Nasus Larynx 2018; 45 (04) 732-739
  • 21 Monini S, Buffoni A, Romeo M. et al. Kabat rehabilitation for Bell's palsy in the elderly. Acta Otolaryngol 2017; 137 (06) 646-650
  • 22 Schirrmacher V. From chemotherapy to biological therapy: a review of novel concepts to reduce the side effects of systemic cancer treatment (review). Int J Oncol 2019; 54 (02) 407-419
  • 23 Hontanilla B, Marre D. Differences between sexes in dissociation and spontaneity of smile in facial paralysis reanimation with the masseteric nerve. Head Neck 2014; 36 (08) 1176-1180
  • 24 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 (06) 651-656
  • 25 Bruins TE, van Veen MM, Werker PMN, Dijkstra PU, Broekstra DC. Associations between clinician-graded facial function and patient-reported quality of life in adults with peripheral facial palsy: a systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg 2021; 147 (08) 717-728