Article

OBJECTIVES: 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. DESIGN: Prospective, randomized trial, controlled. SETTING:
Surgery and Rehabilitation Units, university hospital. SUBJECTS: Consecutive
patients ( n=79, mean age 48 years) who underwent superficial parotidectomy with
facial nerve dissection were randomly divided into two groups. INTERVENTION:
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.
MAIN OUTCOME MEASURES: 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 12th months. RESULTS: Facial
paresis incidence at 1st week 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.
CONCLUSION: Rehabilitation therapy and mirror facial exercises performed
autonomously at home were equally effective for postoperative functional
recovery.

Langue : ANGLAIS