Physical Therapy for Facial Paralysis

Overview

Facial paralysis, also knows as facial palsy, can lead to important functional deficits. These challenges can include oral incompetence, limited eye closure, difficulty with articulating certain words, inability to express emotions, and associated anxiety and depression. Chronic facial palsy can also lead to dysfunctional facial movements and facial tightness. Rehabilitation for facial palsy can help patients regardless of the etiology of the paralysis, and it works complementary to other treatments to optimize outcomes.

What to Expect

During the initial evaluation visit, patients will talk with one of our therapists about how facial palsy is affecting their lives and what the most bothersome symptom(s) are. A comprehensive evaluation will be performed including clinician-graded facial function and symmetry assessments, photographs, videos, and surveys assessing how facial palsy is affecting the lives of patients on a daily basis. We then formulate a facial rehabilitation plan together with patients that includes five main components:

• Patient education about how the facial nerve and muscles work, and expectations of recovery
• Soft tissue stretching and massage
• Strategies to improve facial function, e.g improving the ability to eat, drink and speak
• Movement exercises to specifically retrain facial expression.
• Techniques to minimize involuntary facial movements (synkinesis)

We emphasize self-management strategies for patients as this empowers them to take control of their facial palsy. Further, facial palsy is often a chronic condition and long-term commitment to home exercises is required to obtain the best results. We understand this at the Facial Nerve Center and we work with every single patient to develop an at-home routine which will improve facial function and symmetry while not being overburdensome.

At the Facial Nerve Center, the therapists and surgeons work together to optimize treatment strategies for our patients. For example, we will time the initiation of facial rehabilitation and Botox so that patients get the most out of each treatment. After smile reanimation surgery where a branch of the chewing nerve is used to reinnervate the smile muscles (also known as 5-7 nerve transfer, or masseteric-facial nerve transfer), our therapists help patients learn how to smile by biting down and give them exercises so that, with practice, patients can smile without having to think about it.

Our Team

The Facial Nerve Center is staffed by surgeons, physical therapists, physician assistants and other medical specialists skilled in the evaluation and treatment of facial paralysis. Our team includes Kerry Shanley Camp, PA-C, Madeline Macaluso, FNP-BC, Julia Mellon, NP-C, and Mara Robinson, PT, MS. This combination of medical expertise allows us to help patients improve their appearance, facial function, non-verbal communication and overall well-being.