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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
Italian Journal of Maxillofacial Surgery 2013 August;24(2):69-75
Combination of rehabilitation and eye soft surgery thought to reduce eye disease and the incidence of syncinesia
Di Stadio A.
Maxillo-Facial Pitie Salpetriere, Paris, France
Aim: The aim of this paper was to evaluate the combination between Kabat and neuromuscular therapy with lower eyelid lifting, in treatment of facial nerve paralysis, to optimize functional recovery and decrease the incidence of syncinesia. Through the evaluation of the correct method of facial palsy treatment, by analyzing the decrease of the incidence of syncinesia.
Methods: Twenty-five patients were selected: 15 affected by iatrogenic paralysis, 10 with Bell’s paralysis. Kabat therapy started in all patients within 3 to 7 days after palsy manifestation, except one who started therapy later. All patients who started IV level HB were considered in the study. We changed the rehabilitation technique in consideration of the facial mobility recovery. We used modified eyelid lifting when the superior eyelid started its movement.
Results: In all patients, we achieved facial mobility recovery between I° and II°, according to the H.B scale; this was possible thanks to rehabilitative techniques and eyelid soft surgery.
Conclusion: We achieved a decrease of the incidence of syncinesia, and thus III° H.B never showed in our study. The combination of Kabat and NMR therapy with lower eyelid lifting achieved excellent functional recovery and syncinesia incidence reduction.