Modern approaches to the treatment and rehabilitation of patients with facial neuropathy

Abstract

Facial nerve neuropathy can manifest itself with gross organic and functional disorders. The esthetic defect worsens social adaptation and quality of life. However, there is no consensus, protocol or algorithm of treatment of the patient with this pathology. In article we present a modern way of treatment and rehabilitation of patients with neuropathy of a facial nerve of various etiology. Conservative and surgical types of treatment are applied during the different periods of a disease. Surgical methods of treatment can be divided into two groups: reconstructive, decompressive and also plastic. The choice of a type of operation is defined individually with many factors, including an etiology and time of a 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 appoint additional 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 acute and 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, and blepharography is performed in case of pronounced deficit. As an alternative method, botulinum toxin type A injections are used into the upper eyelid lifting muscle. One of the most effective methods of rehabilitation of patients with facial nerve neuropathy is therapeutic physical education such as neuromuscular retraining with biological feedback. The most optimal combination is the injection of botulinum toxin type A and therapeutic physical education.