Article

The Facial Grading Scale (FGS) is a quantitative instrument used to
evaluate facial function after facial nerve injury. However, quantitative
improvements in function after facial rehabilitation in people with chronic
facial paralysis have not been shown. OBJECTIVE: The objectives of this study
were to use the FGS in a large series of consecutive subjects with facial
paralysis to quantitatively evaluate improvements in facial function after facial
nerve rehabilitation and to describe the management of chronic facial paralysis.
DESIGN: The study was a retrospective review. METHODS: A total of 303 individuals
with facial paralysis were evaluated by 1 physical therapist at a tertiary care
facial nerve center during a 5-year period. Facial rehabilitation included
education, neuromuscular training, massage, meditation-relaxation, and an
individualized home program. After 2 months of home exercises, the participants
were re-evaluated, and the home program was tailored as necessary. All
participants were evaluated with the FGS before the initiation of facial
rehabilitation, and 160 participants were re-evaluated after receiving treatment.
All participants underwent the initial evaluation at least 4 months after the
onset of facial paralysis; for 49 participants, the evaluation took place more
than 3 years after onset. RESULTS: Statistically significant increases in FGS
scores were seen after treatment (P<.001, t test). The average initial score was
56 (SD=21, range=13-98), and the average score after treatment was 70 (SD=18,
range=25-100). LIMITATIONS: A limitation of this study was that evaluations were
performed by only 1 therapist. CONCLUSIONS: For 160 patients with facial
paralysis, statistically significant improvements after facial rehabilitation
were shown; the improvements appeared to be long lasting with continued
treatment. The improvements in the FGS scores indicated that patients can
successfully manage symptoms with rehabilitation and underscored the importance
of specialized therapy in the management of facial paralysis.

Langue : ANGLAIS