Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Management of Synkinesis and Asymmetry in Facial Nerve Palsy: A Review Article

Document Type : Systematic Review

Authors
Abbasali pourmomeny
Sahar Asadi
Department of Physiotherapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
10.22038/ijorl.2014.3216
Abstract
Introduction:
The important sequelae of facial nerve palsy are synkinesis, asymmetry, hypertension and contracture; all of which have psychosocial effects on patients. Synkinesis due to mal regeneration causes involuntary movements during a voluntary movement. Previous studies have advocated treatment using physiotherapy modalities alone or with exercise therapy, but no consensus exists on the optimal approach. Thus, this review summarizes clinical controlled studies in the management of synkinesis and asymmetry in facial nerve palsy.
 
Materials and Methods:
Case-controlled clinical studies of patients at the acute stage of injury were selected for this review article. Data were obtained from English-language databases from 1980 until mid-2013.
 
Results:
Among 124 articles initially captured, six randomized controlled trials involving 269 patients were identified with appropriate inclusion criteria. The results of all these studies emphasized the benefit of exercise therapy. Four studies considered electromyogram (EMG) biofeedback to be effective through neuromuscular re-education.
 
Conclusion: 
Synkinesis and inconsistency of facial muscles could be treated with educational exercise therapy. EMG biofeedback is a suitable tool for this exercise therapy.
Keywords
Bell's palsy
Electromyography biofeedback
Facial palsy
physiotherapy
Synkinesis
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Iranian Journal of Otorhinolaryngology
Volume 26, Issue 4 - Serial Number 4
September and October 2014
Pages 251-256