Facial Rehabilitation as Noninvasive Treatment for Chronic Facial Nerve Paralysis

Emily Karp, Emily Waselchuk, Cynthia Landis, Jill Fahnhorst, Bruce Lindgren, Sofia Lyford-Pike

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


OBJECTIVES: This study aims to evaluate the effectiveness of facial rehabilitation (FR) in patients with chronic facial nerve paralysis (FNP) and describe factors that predict improved facial nerve function after FR in this patient population.

STUDY DESIGN: Retrospective case review.

SETTING: Tertiary referral center.

PATIENTS: Around 241 patients were referred to a university hospital facial rehabilitation (FR) program for FNP between 1995 and 2016. Seventy-six patients met criteria, defined as diagnosis of FNP ≥12 months prior to initiation of FR.

INTERVENTIONS: Each received at least two sessions of directed FR by a single therapist. Techniques employed: neuromuscular retraining, stretching/massage, and active exercise.

MAIN OUTCOMES: Variables affecting outcomes were analyzed to determine association with success of FR as measured by improvement in Facial Grading System (FGS) scale.

RESULTS: Onset of FNP to initiation of FR ranged 12 to 384 months (mean latency = 64.7 months). All patients, age 20 to 89, showed improvement in FGS after FR (mean, 16.54 points, SD 9.35). Positive predictors of FGS improvement after therapy (p-values < 0.05): increased the number of therapy sessions, right side of face being treated for FNP, lower starting FGS score. When controlling for these important variables, time from diagnosis to initiation of therapy was not significantly associated with improvement in FGS score.

CONCLUSION: Facial rehabilitation was associated with improved FGS score regardless of patient age, gender, or latency to facial rehabilitation. As a noninvasive treatment option with positive outcomes, it should be offered to patients with facial nerve paralysis regardless of chronicity.

Original languageEnglish (US)
Pages (from-to)241-245
Number of pages5
JournalOtology and Neurotology
Issue number2
StatePublished - 2019

Bibliographical note

Funding Information:
Address correspondence and reprint requests to Emily Karp, B.S., Sofia Lyford-Pike, MD, c/o Emily Karp, Phillips Wangensteen Building, 516 Delaware Street SE, Suite 8A, Minneapolis, MN 55455; E-mail: [email protected] B.L. received grant from the University of Minnesota’s NIH Clinical and Translational Science Award (UL1TR002494). The rest of the authors disclose no conflicts of interest. Supplemental digital content is available in the text.

Publisher Copyright:
© 2018 Otology and Neurotology, Inc.


  • Facial nerve
  • Facial nerve paralysis
  • Facial rehabilitation
  • Quality of life

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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