The effectiveness of facial exercise therapy in ophthalmic complications of facial nerve palsy and the CADS grading scale as an effective grading system
Author: Christina Lim
Base Hospital / Institution: Queen Victoria Hospital, East Grinstead, UK
Rapid fire oral presentation
Abstract ID: 24-190
Purpose
The effectiveness of facial exercise therapy in facial nerve palsy is well documented in the literature. However, there is no study examining its effect on ophthalmic manifestations of facial nerve palsy. The study reports its impact on the ophthalmic manifestations of facial nerve palsy using the ophthalmic-specific CADS grading system.
Methods
A retrospective case-series of patients aged 18 years or older with facial nerve palsy was performed in a single specialist centre between 2013-2019. Inclusion criteria were ophthalmic involvement, recorded CADS and Sunnybrook grading scale pre- and post-treatment.
Results
A total of 73 patients were identified. There were 24 patients (M=11, F-13) who received facial exercise therapy only (group 1) and 49 patients (M17, F=32) who received combined treatment of facial exercise therapy and eyelid surgery (group 2). The mean ages were 54.8 and 49.7 years respectively. The groups were further sub-divided into early (12 months). In group 1, statistically significant improvements were seen in early (static Asymmetry and Dynamic function), intermediate (Cornea), and late groups (Cornea, static Asymmetry, Dynamic function). No improvement was seen in Synkinesis. The Sunnybrook grading scale was unable to detect changes in the ophthalmic features post-therapy or to report the corneal status.
Conclusion
Facial exercise therapy is likely to improve ophthalmic manifestations of facial nerve palsy, in particular, those with static asymmetry and dynamic function of eye closure. The CADS grading scale is more suitable for the ophthalmic assessment compared to the traditional Sunnybrook or House-Brackmann grading system.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Raman | Malhotra | Queen Victoria Hospital, East Grinstead, UK |
| Ruben | Kannan | Queen Victoria Hospital, East Grinstead, UK |
| Charles | Nduka | Queen Victoria Hospital, East Grinstead, UK |
| Catriona | Neville | Queen Victoria Hospital, East Grinstead, UK |
