The effectiveness of neuromuscular facial retraining combined with electromyography in facial paralysis rehabilitation

OBJECTIVE: The study goal was to present the effectiveness of neuromuscular facial retraining techniques used in combination with electromyography for improving facial function even in cases of longstanding paralysis. STUDY DESIGN AND SETTING: We conducted a retrospective case review in a tertiary neurotology clinic. PATIENTS: Twenty-four patients with facial paralysis received neuromuscular facial retraining between April 1999 and April 2001. The patient sample included 6 males and 18 females, with an average age of 44 years. A control group consisted of 6 patients (4 females and 2 males). RESULTS: All patient groups made significant improvements in function with improved symmetry in dual-channel electromyographic readings and increased facial movement percentages. Some of the percentages of posttreatment facial function were as follows: acoustic neuromas, 93%; Bell's palsy/Ramsay Hunt syndrome, 80%; and facial nerve anastomosis, 71%. Synkinesis was reduced by at least 2 levels in patients who initially demonstrated synkinesis. CONCLUSIONS: Neuromuscular facial retraining exorcises and electromyography are effective for improving facial movements. SIGNIFICANCE: Facial retraining is an excellent example of the plasticity of the central nervous system to reorganize, even in cases of longstanding paralysis.