Facial nerve rehabilitation continues to be
one of the most under-treated area of rehabilitation. Approximately
25% to 30% of patients with Bell's palsy and post-acoustic neuroma
excision are left with incomplete facial nerve function. Problems
such as synkinesis, mass uncontrollable action of facial muscles
create not only cosmetic inconvenience but also functional deficits
with eating, drinking and most importantly communication.
Traditional therapy techniques such as electrical
stimulation and gross facial exercises have been widely use in the
treatment of facial paralysis even though there is evidence that
this is ineffective and even contraindicated. Waxman in 19841 and
Cohan in 19862 have suggested that electrical stimulation may interfere
with neural regeneration and studies proving its efficacy are also
lacking in the literature. Balliet's article in 19853 also demonstrated
that gross non-specific facial exercises typically given to patients
reinforce abnormal movement patterns.