Mime therapy improves facial symmetry in people with long-term facial nerve paresis: a randomised controlled trial

Abstract

Question: What is the effect of mime therapy on facial symmetry and severity of paresis in people with facial nerve paresis?

Design: Randomised controlled trial.

Participants: 50 people recruited from the Outpatient department of two metropolitan hospitals with facial nerve paresis for more than nine months.

Intervention: The experimental group received three months of mime therapy consisting of massage, relaxation, inhibition of synkinesis, and co-ordination and emotional expression exercises. The control group was placed on a waiting list.

Outcome measures: Assessments were made on admission to the trial and three months later by a measurer blinded to group allocation. Facial symmetry was measured using the Sunnybrook Facial Grading System. Severity of paresis was measured using the House-Brackmann Facial Grading System.

Results: After three months of mime therapy, the experimental group had improved their facial symmetry by 20.4 points (95% CI 10.4 to 30.4) on the Sunnybrook Facial Grading System compared with the control group. In addition, the experimental group had reduced the severity of their paresis by 0.6 grade (95% CI 0.1 to 1.1) on the House-Brackmann Facial Grading System compared with the control group. These effects were independent of age, sex, and duration of paresis.

Conclusion: Mime therapy improves facial symmetry and reduces the severity of paresis in people with facial nerve paresis.