Department of Ophthalmology and Visual Sciences.
Facial Nerve Clinic, Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison.
Curr Opin Ophthalmol. 2018 Sep;29(5):469-475. doi: 10.1097/ICU.0000000000000503.
The aim of this study was to describe the current state of physical therapy for facial nerve palsy, the evidence basis for these interventions and how therapy can be integrated with other medical and surgical interventions for facial nerve palsy, as it applies to ophthalmologists, oculoplastic surgeons and other specialists.
Many studies indicate that physical therapy is effective for the rehabilitation of patients with facial nerve palsy and can be used synergistically with interventions administered by physicians, such as targeted botulinum toxin injections. The field is limited by a relative paucity of high-quality randomized controlled trials. Alternative therapies including Brief Electrical Stimulation continue to be studied; however, they lack a scientific rationale and, anecdotally, appear to cause more problems in cases of incomplete facial nerve recovery.
Physical therapy, specifically neuromuscular retraining, is a useful intervention for treating facial nerve palsy. Care for these patients is best delivered in a multidisciplinary setting in which physical therapy and medical or surgical interventions can be closely integrated. Further study aimed at standardizing physical therapy and optimizing the integration of this with other treatments for facial nerve palsy are needed.
本研究旨在描述面神经麻痹的物理治疗现状、这些干预措施的证据基础,以及物理治疗如何与面神经麻痹的其他医学和手术干预措施相结合,适用于眼科医生、眼整形外科医生和其他专家。
许多研究表明,物理治疗对面神经麻痹患者的康复是有效的,并且可以与医生进行的干预措施(如靶向肉毒毒素注射)协同使用。该领域的局限性在于相对缺乏高质量的随机对照试验。包括Brief Electrical Stimulation 在内的替代疗法仍在研究中;然而,它们缺乏科学依据,而且在面神经不完全恢复的情况下,据报道会引起更多问题。
物理治疗,特别是神经肌肉再训练,是治疗面神经麻痹的一种有用的干预措施。这些患者最好在多学科环境中接受治疗,在这种环境中,物理治疗和医学或手术干预可以紧密结合。需要进一步的研究来标准化物理治疗,并优化其与面神经麻痹其他治疗方法的结合。