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Otolaryngol Head Neck Surg. 2012 Jan;146(1):40-5. doi: 10.1177/0194599811424125. Epub 2011 Sep 30.

Mirror biofeedback rehabilitation after administration of single-dose botulinum toxin for treatment of facial synkinesis.

Author information

1
Department of Otolaryngology, University of Tokushima School of Medicine, Tokushima, Japan. otazjp@clin.med.tokushima-u.ac.jp

Abstract

OBJECTIVE:

The efficacy of facial biofeedback rehabilitation with a mirror after administration of a single dose of botulinum A toxin on facial synkinesis was examined in patients with chronic facial palsy.

STUDY DESIGN:

Prospective clinical study.

SETTING:

University hospital.

SUBJECTS AND METHODS:

The present study includes 8 patients with Bell palsy and 5 with herpes zoster oticus showing facial synkinesis. A single dose of botulinum A toxin was used as the initial process of facial rehabilitation. Patients then continued a daily facial biofeedback rehabilitation with a mirror at home. They were instructed to keep their eyes symmetrically open using a mirror during mouth movements. The degree of oral-ocular synkinesis was evaluated by the degree of asymmetry of eye opening width during mouth movements (% eye opening).

RESULTS:

After administration of a single dose of botulinum A toxin, temporary relief of facial synkinesis was observed in all patients. Patients were then instructed to continue the facial biofeedback rehabilitation with a mirror for 10 months. The mean values of the percent of eye opening during 3 designated mouth movements that included lip pursing /u:/, teeth baring /i:/, and cheek puffing /pu:/ increased significantly after 10 months when the effects of botulinum A toxin had completely disappeared.

CONCLUSION:

These findings demonstrate that facial biofeedback rehabilitation with a mirror after administration of a single dose of botulinum A toxin is a long-lasting treatment of established facial synkinesis in patients with chronic facial palsy.

PMID:
21965443
DOI:
10.1177/0194599811424125
[Indexed for MEDLINE]

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