Mandibular range of motion in patients with idiopathic peripheral facial palsy

Abstract

regardi ng orofacial motor assessment in facial paralysis, quantitative measurements of the face are being used to establish diagnosis, prognosis and treatment planning. Aim:To assess the prevalence of changes in mandibular range of motion in individuals with peripheral facial paralysis.Materials and Methods: prospective study. We had 56 volunteers, divided in two groups: G1 made up of 28 individuals with idiopathic facial paralysis (6 males and 22 females); 14 with manifestations on the right side of the face and 14 on the left side; time of onset varied between 6-12 months; G2 with 28 healthy individuals paired by age and gender to G1. in order to assess mandibular range of motion, a digital caliper was used. The following measurements were made: 1) middle line; 2) maximum oral opening; 3) lateralization to the right; 4) lateralization to the left; 5) protrusion; 6) horizontal overlap.Results: Statistically significant differences between the groups were observed for maximum oral opening, lateralization to the left and protrusion. G1 presented smaller measurement values than G2.Conclusion: patients with facial paralysis present significant reduction of mandibular range of motion. The results support the suggestion of incorporating functional evaluation of the temporomandibular joint to the existing facial paralysis clinical assessment protocols. . The speech and hearing therapist's assessment must encompass instruments which enable functional measuring. These measures will enable treatment and help check for treatment efficacy. ORIgInAL ARTIcLEThe speech and hearing quantitative measures can be obtained through surface electromyography; photogrammetry; digital caliper; cephalometry and, more recently, the facial movement quantification system, in 3-d video [11][12][13][14][15] . The qualitative measures may be obtained through clinical protocols and self-perception questionnaires 16,17 . in speech and hearing therapy practice concerning facial paralysis patients, it is not a routine to completely assess orofacial functions, because the main complaint is associated with facial movements. nonetheless, frequent have been the reports of pain in the temporomandibular joint (TMJ) and a reduction in speech articulatory movements. in the bibliography search, we did not find specific studies on the relationship between facial paralysis and TMJ function. The TMJs are important structures of the stomatognathic system, since they enable mandibular movements and functions such as suction, swallowing, chewing and speech 18 . Literature states that the range of mandibular motion is associated with TMJ integrity and the action of skeletal muscles [19][20][21] . The TMJ needs to support and accommodate occlusal, muscular and neck adaptations. When the demand for functional adaptations exceeds the TMJ functional and structural tolerance, the patient may develop signs and symptoms of temporomandibular disorders (TMd) [22][23][24] , causing changes to mandibular movements and to the stomatognathic functions associated with them 1...

Paralisia facial periférica: atividade muscular em diferentes momentos da doença

“…The results of the study suggest that for each group with longer duration of the paralysis, the sequelae of the facial lesion are more evident. According to the literature, the change in facial muscle functions is a condition, which may be associated to vegetative alterations such as the absence or reduction of tearing, vascular alterations, or co-contractions of surrounding muscles in the case of functional muscle imbalance, as in the case of facial palsy (25) . A recent prospective study, which evaluated 259 patients with peripheral facial palsy (19) , concluded that despite the importance of clinical evaluation protocols in the follow-up of facial palsy patients' recovery, the evaluation by invasive EMG is able to provide more accurate data on the degree of facial motor impairment of the patient and, therefore, it allows predicting the possibility of facial movement recovery.…”

A Facial Chuna Manual Therapy for Peripheral Facial Nerve Palsy

“…Treatment of the temporomandibular joint with CMT has been shown to help improve mandibular range [12]. The mandibular range of motion in patients with facial palsy is an essential factor because mandible movements enable changes in the intraoral spaces, allowing for free movements of the tongue and the soft tissue [23]. In addition, some articles denote that patients with facial palsy have a significant reduction in the mandibular range of motion when compared to the control group [12].…”

Speech-language-hearing instruments to assess peripheral facial palsy: an integrative literature review

“…Other articles were found 10,18,19,22,26,34 in which the HB scale was used by a neurologist or SLH therapist.…”