Publication date: Available online 22 May 2019
Source: Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): V. Venables, C. Neville, T. Gwynn, R.Y. Kannan, C. Nduka
Abstract
Introduction
Lower motor neurone facial paralysis (LMNFP) is often viewed by the general public and wider non-facial palsy fraternity, as a cosmetic issue rather than a functional one. In this article, we sought to determine the severity and frequency of oro-motor dysfunction in LMNFP and assess the benefits of physical therapy and rehabilitation on this cohort.
Patients & Methods
A prospective study at our institute was conducted over a one-year period (2015-16), involving adult LMNFP patients with significant oro-motor dysfunction. The exclusion criteria was (i) pre-existing oro-motor dysfunction and (ii) within six months of facial palsy onset. The assessment tools used were (i) The Facial Disability Index (FDI), (ii) IPREDD or Inventory of Patient Reported Eating and Drinking Dysfunction for mastication and (iii) a be-spoked Visual Analogue Scale (VAS) based on focus group discussions.
Results
Of the 183 new clinic referrals, FDI identified that 14% of LMNFP patients had significant oro-motor dysfunction. IPREDD analysis showed that 74% of this cohort had masticatory problems while the VAS indicated significant oro-motor dysfunction as well in those with LMNFP. Following speech and facial therapy, IPREDD-focussed symptoms were reduced from 74% to 43% (shown to be significant), while VAS similarly showed a significant reduction in symptoms (Two-tailed, paired student t-test p<0.01).
Discussion
Oro-motor function is a significant sequelae of facial paralysis. Facial rehabilitation, both physical and psychological, can help reduce patients distress and improve oro-motor function, without the need for surgical intervention in the first instance.
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