Features of facial asymmetry following incomplete recovery from facial paralysis.
OBJECTIVE
The purpose of this study is to investigate peculiar patterns of facial asymmetry following incomplete recovery from facial paralysis that require optimal physical therapy for effective facial rehabilitation, and to decrease the incidence of avoidable facial sequelae.


METHODS
This study involved 41 patients who had facial sequelae following the treatment of various facial nerve diseases from March 2000 to March 2007. All patients with a followup of at least 1 year after the onset of facial paralysis or hyperactive function of the facial nerve were evaluated with the global and regional House-Brackmann (HB) grading systems. The mean global HB scores and regional HB scores with standard deviations were calculated. Other factors were also analyzed.


RESULTS
Four patterns of facial asymmetry can be observed in patients with incomplete facial recovery. The most frequently deteriorated facial movement is frontal wrinkling, followed by an open mouth, smile, or lip pucker in patients with sequelae following facial nerve injury. The most common type of synkinesis was unintended eye closure with an effort to smile.


CONCLUSIONS
We described common configurations of facial asymmetry seen in incomplete recovery following facial nerve injury in an attempt to develop an optimal strategy for physical therapy for complete and effective facial recovery, and to decrease the incidence of avoidable sequelae.
Kim
Jin
J
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.
Lee
Hyung Rok
HR
Jeong
Jun Hui
JH
Lee
Won Sang
WS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005145:Face / Q000503:physiopathology; D005146:Facial Asymmetry / Q000503:physiopathology*; D005154:Facial Nerve / Q000473:pathology; D020220:Facial Nerve Injuries / Q000503:physiopathology / Q000628:therapy; D005158:Facial Paralysis / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D016896:Treatment Outcome