Neuromuscular Facial Retraining
Evaluation Treatment
Weakness or paralysis of a side of the face can result in distorted facial expression and problems with speaking and chewing/eating. Difficulties in these areas affect not only the way others see us but also the way we perceive ourselves.
Recognizing the unique rehabilitation needs of individuals with facial paralysis and the fact that there are few programs nationwide that provide neuromuscular facial rehabilitation, the Center for Communication and Swallowing Disorders established a comprehensive program for the rehabilitation of facial paralysis or facial weakness.
The following types of post-acute conditions may warrant evaluation and treatment through the Neuromuscular Facial Retraining Program:
- Bell's palsy
- Ramsay Hunt Syndrome
- Acoustic neuroma and other tumors resulting in facial paralysis
- Traumatic injury
- Cancer
- Post-surgical facial reanimation procedures
Evaluation
A physician must refer patients for evaluation and therapy. The evaluation process begins with a review of the patient's medical records and documentation of the medical history. The initial evaluation typically takes two to three hours.
Since patients normally respond best to the treatment techniques when visible signs of functional recovery have occurred, a period of 3-18 months post onset of the facial paralysis is a typical time frame for an initial evaluation through the program.
Clinical assessment includes:
- Videotaping the patient's face at rest, during a number of facial movements, and when speaking
- Rating facial movement
Along with the results of the evaluation, a treatment program will be discussed with the patient and family members at the time of the assessment. A report will be sent to the referring physician.
Treatment
Our rehabilitation services are designed for patients to regain symmetry of the face while at rest, to regain symmetry during facial movement and expression, and to maximize speech and swallowing functions.
Treatment programs have demonstrated that specific and intense retraining can improve facial nerve function.
The Neuromuscular Facial Retraining Program emphasizes controlled movement and symmetry, which is in contrast to many traditional programs that stress speed and strength of movement. The program is designed to be cost effective, since the patient is carefully instructed in the exercises that can be carried out at home.
The treatment program addresses the unique rehabilitation problems associated with facial paralysis due to distorted facial expression and any associated speech and eating/swallowing problems.
Therapy includes:
- Educating and counseling the patient about the facial musculature, thereby assisting him/her in understanding the purpose of the exercises
- Providing training techniques and exercises which are intended to be carried out by the patient at home
Any return clinic appointments are designed to monitor the patient's progress, provide further patient and family education, and upgrade the individualized therapy program as necessary to optimize functioning
The retraining process relies on active patient participation in the program. Patients must be motivated and cognitively able to pursue an intense home therapy program over a prolonged period of time for maximum potential benefit.