Int. Adv. Otol. 2009; 6(1); 39-45

Selective rehabilitation of posttraumatic facial palsy: The influence of previous operation and timing.
Stankovic Ivona,  Milisavljevic Dusan , Djordjevic Gordana, Dimitrijevic Lidija,  Colovic Hristina  Clinic for physical therapy and rehabilitation, Clinical center Nis, Serbia. Serbiaivona@medfak.ni.ac.yu

Objective: Patients with posttraumatic facial palsy are not homogenous when neuromuscular dysfunction is analyzed and
nonselective therapy causes unequal improvement after physical therapy.

Study design: Prospective review of patient’s records.
Setting: Tertiary referral center.

Materials and Methods: In order to verify the effects of physical therapy of posttraumatic facial palsy according to the degree
of dysfunction, a prospective study on 24 patients was performed by dividing them into four groups: altered initiation of
movement, difficulty with facilitation, difficulty with movement control and difficulty with relaxation. Seven patients were
previously operated, and the others were treated medicamentously.
Interventions: Selective therapy of facial palsy included application of physical procedures and training of facial musculature.

Main Outcome Measures: Facial Grading System (FGS) and Facial disability index (FDI) were used for evaluation of
treatment.

Results: Selective therapy of posttraumatic facial palsy resulted in improvement of all the parameters. The rate of improvement
was comparable in FGS and FDI scale. Spontaneous facial nerve recovery showed lower values of improvement for both
scales. Significant improvement of selective therapy appeared mostly after 30 days of treatment. Previously operated patients
had lower improvement rate. Early selective physical therapy for posttraumatic facial palsy produced significantly better final
outcome.

Conclusion: Selective and individual approach to physical therapy of posttraumatic facial palsy can have important
therapeutical influence on the final outcome. The type and degree of neuromuscular dysfunction must be used for selection of
physical therapy.