title: Effectiveness of facial exercise therapy for facial nerve dysfunction after superficial parotidectomy: a randomized controlled trial.
abstract: OBJECTIVE
  To compare the effectiveness of a daily home-based facial exercise therapy with a supervised rehabilitation technique for the treatment of postoperative facial dysfunction in patients undergoing conventional superficial parotidectomy.
  
  
  METHODS
  Prospective, randomized trial, controlled.
  
  
  METHODS
  Surgery and Rehabilitation Units, university hospital.
  
  
  METHODS
  Consecutive patients ( n=79, mean age 48 years) who underwent superficial parotidectomy with facial nerve dissection were randomly divided into two groups.
  
  
  METHODS
  Control group (CG) were given a daily homework manual to perform ordinary postoperative facial mimic exercises autonomously in front of the mirror at home. Experimental group (EG) patients with moderate-severe paresis received supervised rehabilitation therapy that consisted in weekly sessions with facial exercises and massages and performed daily facial exercises at home. EG patients with slight paresis were instructed to undertake self-massage and mirror exercises.
  
  
  METHODS
  Postoperative dysfunction of facial nerve and branches was quantified measuring the prevalence, magnitude and duration of paresis by the House-Brackmann Facial Nerve Grading System up to 12thmonths.
  
  
  RESULTS
  Facial paresis incidence at 1stweek was 77.2%, being the marginal-mandibular nerve the most affected (64.5%). No statistically significant differences were found at any time of the study when comparing the frequency, magnitude and duration of paresis between EG and CG and among patients who had presented moderate-severe paresis. In the absence of intraoperative nerve injury, complete recovery of facial mobility was observed within 12 months, regardless of treatment group.
  
  
  CONCLUSIONS
  Rehabilitation therapy and mirror facial exercises performed autonomously at home were equally effective for postoperative functional recovery.
authors.affiliation: 1 Department of Oral and Maxillofacial, Virgen del Rocio University Hospital, University of Seville, Seville, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Infante-Cossio
authors.affiliation: 1 Department of Oral and Maxillofacial, Virgen del Rocio University Hospital, University of Seville, Seville, Spain.
authors.forename: Victoria-Eugenia
authors.initials: VE
authors.lastname: Prats-Golczer
authors.affiliation: 1 Department of Oral and Maxillofacial, Virgen del Rocio University Hospital, University of Seville, Seville, Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Lopez-Martos
authors.affiliation: 2 Department of Clinical Neurophysiology, Virgen del Rocio University Hospital, Seville, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Montes-Latorre
authors.affiliation: 3 Department of Rehabilitation, Virgen del Rocio University Hospital, Seville, Spain.
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Exposito-Tirado
authors.affiliation: 1 Department of Oral and Maxillofacial, Virgen del Rocio University Hospital, University of Seville, Seville, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Gonzalez-Cardero
mesh_terms: D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D005158:Facial Paralysis / Q000209:etiology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010306:Parotid Gland / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000534:rehabilitation; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D012648:Self Care / Q000379:methods*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
keywords: Paralysis; exercise programme; facial paralysis; rehabilitation interventions