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

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.

• Authors: Takahiro Azuma, Katsuhiko Nakamura, Mika Takahashi, Seizo Ohyama, Naoki Toda, Hidetaka Iwasaki, Bukasa Kalubi, Noriaki Takeda
• Journal: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (Otolaryngol Head Neck Surg) Vol. 146 Issue 1 Pg. 40-5 (Jan 2012) ISSN: 1097-6817 [Electronic] England
• PMID: 21965443 (Publication Type: Clinical Trial, Comparative Study, Journal Article)

Chemical References

• Neuromuscular Agents
• Botulinum Toxins, Type A

Topics

• Adult
• Aged
• Biofeedback, Psychology (drug effects)
• Botulinum Toxins, Type A (administration & dosage)
• Chronic Disease
• Dose-Response Relationship, Drug
• Face
• Facial Muscles (physiopathology)
• Facial Paralysis (complications, drug therapy, physiopathology)
• Female
• Follow-Up Studies
• Humans
• Injections, Intramuscular
• Male
• Middle Aged
• Muscle Contraction (drug effects, physiology)
• Neuromuscular Agents (administration & dosage)
• Prospective Studies
• Synkinesis (drug therapy, etiology, physiopathology)
• Treatment Outcome