Abstract

Background: Peripheral facial nerve palsy (FNP) is sometimes managed in rehabilitation medicine. Bell’s palsy is the most common cause of FNP. Approximately 31% of patients with Bell’s palsy who did not receive appropriate treatment may suffer from incomplete recovery. In severe cases, the facial muscles shorten due to frequent co-contraction with the synkinesis in the chronic phase. Since intra-oral massage (IOM) can be easily applied to outpatients without using any special devices, we applied it to the complications following severe FNP in the chronic stage for an outpatient. It is designed to stretch the shortened facial muscles directly from the oral cavity. Objective: The aim of the present study was to investigate the effect of IOM on muscle stiffness with the facial nerve palsy patients in the chronic stage that could not be relieved by the conventional superficial massage. Methods: To objectively assess the change in muscle stiffness, the findings were compared with sonoelastography, which is widely used for diagnosing breast cancer, before and after training. Results: At pre-IOM, the cheek of the affected side was significantly harder than that of the unaffected side. The strain increased significantly on the affected side after IOM. The cheek of the affected side became softer to the same degree as the unaffected side. Conclusion: Structural changes after IOM were objectively evaluated using sono-elastography. Keywords: Facial nerve palsy, synkinesis, rehabilitation, sono-elastography.

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