MODERN APPROACHES TO THE TREATMENT AND REHABILITATION OF PATIENTS WITH FACIAL NEUROPATHY

1 Zavaliy L.B., 1,2 Petrikov S.S., 1 Ramazanov G.R., 2 Kasatkin D.S., 1 Chekhonatskaya K.I.

1 N.V. Sklifosovsky Research Institute of Emergency Medicine, Mosсow, Russian Federation
2 A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation


Abstract:

Facial nerve neuropathy can manifest itself with gross organic and functional disorders. The esthetic defect worsenssocial adaptation and quality of life. However, there is no consensus, protocol or algorithm of treatment of the patientwith this pathology. In article we present a modern way of treatment and rehabilitation of patients with neuropathy ofa facial nerve of various etiology. Conservative and surgical types of treatment are applied during the different periodsof a disease. Surgical methods of treatment can be divided into two groups: reconstructive, decompressive and alsoplastic. The choice of a type of operation is defined individually with many factors, including an etiology and time ofa disease. Both the new and tested by time techniques are applied. Conservative therapy includes corticosteroids,antiviral, antibacterial drugs depending on a clinical situation. Traditionally specialists of policlinics and hospitals appointadditional therapy (group B vitamins, cholinesterase inhibitors, antioxidants, neuroprotectors, nootropic drugs), however single small researches couldn’t enforce these drugs recommendations. Botulinum toxin type A is effective in the acuteand chronic periods of a disease. Depending on a clinical situation of botulinum toxin type A are injected both in affected,and in healthy part of the face. Patients with incomplete eye closure are given keratoprotection as early as possible, andblepharography is performed in case of pronounced deficit. As an alternative method, botulinum toxin type A injectionsare used into the upper eyelid lifting muscle. One of the most effective methods of rehabilitation of patients with facialnerve neuropathy is therapeutic physical education such as neuromuscular retraining with biological feedback. The mostoptimal combination is the injection of botulinum toxin type A and therapeutic physical education.

Keywords: facial nerve, facial neuropathy, Bell palsy, facial asymmetry, botulinum therapy, botulinum toxin type A, rehabilitation, Kabat

For citation: Zavaliy L.B., Petrikov S.S., Ramazanov G.R., Kasatkin D.S., Chekhonatskaya K.I Modern approaches to the treatment and rehabilitation of patients with facial neuropathy. Bulletin of rehabilitation medicine. 2020; 96 (2): 59-67. https://doi.org/10.38025/2078-1962-2020-96-2-59-67



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