MODALITIES IN THE REHABILITATION FOR FACIAL NERVE PARESIS

Abstract

The facial nerve (nervus facialis), as the seventh cranial nerve, plays a crucial role in the motor, sensory, and parasympathetic innervation of the face, and its impairment represents a significant functional and aesthetic problem that may also have pronounced psychosocial consequences. The most common idiopathic form of facial nerve damage is Bell’s palsy, which is characterized by the sudden onset of unilateral weakness of the facial muscles, often accompanied by impaired eye closure, speech, and facial expression. Timely and appropriately structured rehabilitation plays a key role in preventing permanent sequelae and in accelerating functional recovery. The aim of this study was to analyze the frequency of facial nerve palsy in relation to age, occupation, and etiology, to examine the presence of comorbidities, and to assess the effectiveness of applied physical therapy modalities through changes in the degree of nerve impairment according to the House–Brackmann scale, a standardized instrument for evaluating facial nerve function. The study had a retrospective–prospective design and included 43 patients diagnosed with facial nerve palsy who were treated at the Department of Physical Medicine and Rehabilitation of the Cantonal Hospital Bihać. The degree of facial nerve damage was assessed at the beginning and at the end of the therapeutic process using the House–Brackmann scale, which enabled objective monitoring of recovery. Various physical therapy modalities were applied, including electrotherapy, kinesiotherapy, manual therapy, galvanization, electrophoresis, and thermotherapy, individually tailored according to the patients’ clinical condition. The results demonstrated a statistically significant improvement in facial nerve function after the applied therapy (p < 0.05), with the majority of patients achieving recovery of four grades on the House–Brackmann scale. A significant correlation was also found between recovery and age, occupation, etiology, type of lesion, sex, and the presence of comorbidities, indicating the multifactorial nature of the rehabilitation process. Viral infections were identified as the most common cause of nerve damage, while hypertension and diabetes mellitus were the most prevalent comorbid conditions. The findings of this study confirm that the combination of electrotherapy and kinesiotherapy has a significant therapeutic effect in the rehabilitation of facial nerve palsy, contributes to faster and more complete recovery, and justifies their use as a standard component of modern rehabilitation approaches in clinical practice.