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Rehabilitation Postfacial Reanimation Surgery After Removal of Acoustic Neuroma: A Case Study

Wilson, Christopher M. PT, DPT, GCS; Ronan, Susan L. PT, DPT, PCS

Journal of Neurologic Physical Therapy: March 2010 - Volume 34 - Issue 1 - pp 41-49
doi: 10.1097/NPT.0b013e3181cfc324
Case Study

Background and Purpose: Facial paralysis can have a significant negative impact on an individual's social, physical, and emotional well-being; however, little information has been reported on the efficacy of physical therapy interventions for this condition. The purpose of this case study was to describe the details of a physical therapy evaluation and intervention for a patient who underwent facial muscle transfer after resection of acoustic neuroma.

Case Description: A 29-year-old woman underwent left-sided facial reanimation surgery, which included transplantation of the temporalis muscle and platysma muscle to the corner of the mouth.

Intervention: The patient received 30 sessions of physical therapy that included electrical stimulation, biofeedback, lymphatic drainage, home exercises and facial stretching, and scar management.

Outcomes: The patient exhibited an improvement in the Composite score of the Sunnybrook Facial Grading System from 17 to 41. She was able to regain function of the left side of her face with gains in expressions of smiling, frowning, and puckering, but symmetry was not completely restored. The patient had chronic difficulty with left-sided lymphedema, requiring frequent manual lymphatic drainage.

Discussion: Data from this case study suggest that physical therapy management improves functional outcomes for individuals with postoperative changes in facial motor function from facial reanimation surgery. Further research is required to explore factors that influence the rate and extent of recovery derived from physical therapy interventions.

Department of Physical and Occupational Therapy (C.M.W.), William Beaumont Hospital, Troy, Michigan; Department of Physical Therapy (C.M.W.), School of Health Sciences, Oakland University in Rochester, Michigan; and Department of Physical Therapy (S.R.), New York Medical College, School of Public Health, Valhalla, New York.

Address correspondence to: Christopher M. Wilson, E-mail:

© 2010 Neurology Section, APTA