Department of Physical and Occupational Therapy, William Beaumont Hospital, Troy, Michigan, USA.
J Neurol Phys Ther. 2010 Mar;34(1):41-9. doi: 10.1097/NPT.0b013e3181cfc324.
Facial paralysis can have a significant negative impact on an individual's social, physical, and emotional well-being; however, little information has been reported on the efficacy of physical therapy interventions for this condition. The purpose of this case study was to describe the details of a physical therapy evaluation and intervention for a patient who underwent facial muscle transfer after resection of acoustic neuroma.
A 29-year-old woman underwent left-sided facial reanimation surgery, which included transplantation of the temporalis muscle and platysma muscle to the corner of the mouth.
The patient received 30 sessions of physical therapy that included electrical stimulation, biofeedback, lymphatic drainage, home exercises and facial stretching, and scar management.
The patient exhibited an improvement in the Composite score of the Sunnybrook Facial Grading System from 17 to 41. She was able to regain function of the left side of her face with gains in expressions of smiling, frowning, and puckering, but symmetry was not completely restored. The patient had chronic difficulty with left-sided lymphedema, requiring frequent manual lymphatic drainage.
Data from this case study suggest that physical therapy management improves functional outcomes for individuals with postoperative changes in facial motor function from facial reanimation surgery. Further research is required to explore factors that influence the rate and extent of recovery derived from physical therapy interventions.
面瘫会对个人的社交、身体和情感健康产生重大负面影响；然而，关于物理治疗干预对此病症的疗效的信息却很少。本病例研究的目的是描述一位接受听神经瘤切除后面部肌肉移植后进行物理治疗评估和干预的患者的详细情况。
一位 29 岁的女性接受了左侧面部复明手术，包括将颞肌和颈阔肌移植到口角。
患者接受了 30 次物理治疗，包括电刺激、生物反馈、淋巴引流、家庭锻炼和面部拉伸以及疤痕管理。
患者的桑尼布鲁克面部分级系统综合评分从 17 分提高到 41 分。她能够恢复左侧面部的功能，在微笑、皱眉和噘嘴方面都有了改善，但对称性并未完全恢复。患者左侧慢性淋巴水肿困难，需要经常进行手动淋巴引流。
本病例研究的数据表明，物理治疗管理可改善因面部再生动手术导致面部运动功能改变的个体的功能结果。需要进一步研究探讨影响物理治疗干预恢复速度和程度的因素。
