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Physical therapy for facial nerve palsy: applications for the physician

van Landingham, Suzanne W.a; Diels, Jacquelineb,c; Lucarelli, Mark J.a

Current Opinion in Ophthalmology: September 2018 - Volume 29 - Issue 5 - p 469–475
doi: 10.1097/ICU.0000000000000503

Purpose of review The aim of this study was to describe the current state of physical therapy for facial nerve palsy, the evidence basis for these interventions and how therapy can be integrated with other medical and surgical interventions for facial nerve palsy, as it applies to ophthalmologists, oculoplastic surgeons and other specialists.

Recent findings Many studies indicate that physical therapy is effective for the rehabilitation of patients with facial nerve palsy and can be used synergistically with interventions administered by physicians, such as targeted botulinum toxin injections. The field is limited by a relative paucity of high-quality randomized controlled trials. Alternative therapies including Brief Electrical Stimulation continue to be studied; however, they lack a scientific rationale and, anecdotally, appear to cause more problems in cases of incomplete facial nerve recovery.

Summary Physical therapy, specifically neuromuscular retraining, is a useful intervention for treating facial nerve palsy. Care for these patients is best delivered in a multidisciplinary setting in which physical therapy and medical or surgical interventions can be closely integrated. Further study aimed at standardizing physical therapy and optimizing the integration of this with other treatments for facial nerve palsy are needed.

aDepartment of Ophthalmology and Visual Sciences

bFacial Nerve Clinic, Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison

cFacial Retraining LLC, McFarland, Wisconsin, USA

Correspondence to Mark J. Lucarelli, MD, FACS, 2870 University Avenue, Suite 108, Madison, WI 53705, USA. Tel: +1 608 263 4823; e-mail:

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