摘要

Objectives: 1)review the rehabilitation of patients with facial palsy in acute (<3 months after the onset) and late (>3 months after the onset) periods of the disease; 2)assess the effectiveness of various techniques in different periods of the disease and develop the optimal approach for recovery. Introduction: Patients with facial nerve palsy suffer from asymmetry of the face and impaired muscle activity. This symptoms dramatically reduce patient's quality of life and can lead to severe psychological problems, including low self-esteem, social isolation, anxiety and depression. That is why the rehabilitation after the facial nerve palsy is extremely important for patients in both, aesthetic and psychological aspects. Materials / method: Patients were divided into two groups : acute (4 patients) and late stage (6 patients) of facial palsy. For the patients in acute stage only botulinum toxin was injected into hyperactive muscles on the healthy side. In the late stage group the botulinum toxin was injected on both paralyzed and non-paralyzed sides in hypertonic and synkinetic muscules. Then hyaluronic acid fillers were injected to achieve symmetry in the volume of the face and produce myomodulation. The House-Brackmann scale was used for evaluation in the acute stage and the Sunnybrook scale — in the late stage of the disease. Results: Improvement on the House-Brackmann scale was observed in 100% patients with acute nerve injury.The botulinum therapy accelerated the recovery of nerve function in comparison with the control group. Four patients (66.6%) in late stage of facial palsy showed significant improvement according to the Sunnybrook scale in two weeks after the botulinum therapy. Injection of hyaluronic acid fillers helped to achieve visible symmetry of the face and improve the deficit of volume in both affected and non-affected side. Of note, both patients without effect in the late stage had complete facial palsy. Conclusion: 1) Botulinum therapy is a good therapeutic option for the rehabilitation of patients after facial palsy in both acute and late stage of the disease. 2) Hyaluronic acid fillers are recommended for achieving the symmetry in volume of the face . 3) Complete facial palsy in the late postoperative period is a negative prognostic factor for the effectiveness of botulinum therapy.