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No negative effects of surface electrical stimulation for facial paralysis
Introduction Does electrical stimulation (ES) of denervated muscles delay or even prevent reinnervation, or increase aberrant reinnervation and therefore synkinesis? This retrospective study evaluated the outcome with and without surface ES of patients with acute denervated facial muscles.
Methods ES effect was analyzed in two experiments: First experiment involved 39 patients (6 with home-based ES, median 17.5 months) undergoing facial nerve reconstruction surgery. Time to recovery of volitional movements was analyzed. The second experiment involved 13 patients (7 with ES, median 19 months) with spontaneous reinnervation. Sunnybrook and eFACE scoring provided functional outcome measures.
Results Trends for earlier onset of reinnervation were observed after facial nerve reconstruction surgery with ES (median (IQR) 4.5(3.0, 5.25) vs. 5.7(3.5, 9.5) months; p = 0.198). After spontaneous reinnervation less synkinesis was noted (Sunnybrook synkinesis: 3.0(2.0, 3.0) vs. 5.5(4.75, 7.0); p = 0.022) with ES. The eFACE score showed less synkinesis in patients with ES especially in midfacial region (p = 0.01) as well.
Conclusion We find no evidence that ES prevents or slows down reinnervation or increases synkinesis in facial paralysis.
10 June 2020 (online)
© Georg Thieme Verlag KG
Stuttgart · New York