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KMID : 1038220220490050633
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Archives of Plastic Surgery
2022 Volume.49 No. 5 p.633 ~ p.641
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Comparative Study of Multimodal Therapy in Facial Palsy Patients
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Neville Catriona
Gwynn Tamsin
Young Karen
Jordan Elizabeth
Malhotra Raman
Nduka Charles
Kannan? Ruben Yap
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Abstract
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Introduction: In chronic facial palsy, synkinetic muscle overactivity and shortening causes muscle stiffness resulting in reduced movement and functional activity. This article studies the role of multimodal therapy in improving outcomes.
Methods: Seventy-five facial palsy patients completed facial rehabilitation before being successfully discharged by the facial therapy team. The cohort was divided into four subgroups depending on the time of initial attendance post-onset. The requirement for facial therapy, chemodenervation, or surgery was assessed with East Grinstead Grade of Stiffness (EGGS). Outcomes were measured using the Facial Grading Scale (FGS), Facial Disability Index, House-Brackmann scores, and the Facial Clinimetric Evaluation scale.
Results: FGS composite scores significantly improved posttherapy (mean-standard deviation, 60.13?±?23.24 vs. 79.9?±?13.01; confidence interval, ?24.51 to ?14.66, p?
Conclusions: This study shows that multimodal facial rehabilitation in the management of facial palsy is effective, even in patients with chronically neglected synkinesis. In terms of the latency periods between facial palsy onset and treatment initiation, patients presenting later than 2 years were still responsive to multimodal treatment albeit to a lesser extent, which we postulate is due to increasing muscle contracture within their facial muscles.
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KEYWORD
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facial paralysis, synkinesis, botulinum toxins-type A, physical therapy modalities, surgery, plastic
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