Affiliations: [a] Department of Physical Therapy, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil
| [b] Department of Neurology, University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| [c] Department of Head and Neck Surgery, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil
| [d] Institute for Studies in Public Health (IESC), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
Correspondence:
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Address for correspondence: Márcia Gonçalves e Silva Targino da Costa, Instituto Nacional de Câncer, Hospital do Câncer I, Serviço de Fisioterapia, Rua Washington Luiz 35, Centro, Rio de Janeiro/RJ, CEP: 20230-024, Brazil. E-mail: [email protected].
Abstract: BACKGROUND:Facial nerve dysfunction can be a devastating trouble for post-parotidectomy patients. OBJECTIVE:To assess rehabilitation outcomes concerning patients with post-parotidectomy facial nerve dysfunction, comparing benign versus malignant neoplasms. METHODS:Prospective study enrolling adults who underwent parotidectomy with facial nerve sparing between 2016 and 2020. The Modified Sunnybrook System (mS-FGS) was used for facial assessments. Physiotherapy began on the first post-operative day with a tailored program of facial exercises based on Neuromuscular Retraining, to be performed at home 3 times/day. From the first outpatient consultation, Proprioceptive Neuromuscular Facilitation was added to the treatment of cases with moderate or severe facial dysfunctions. RESULTS:Benign and malignant groups had a statistically significant improvement in mS-FGS (p < 0.001 and p = 0.005, respectively). There was no significant difference between groups regarding treatment duration or number of physiotherapy sessions performed. The history of previous parotidectomy resulted in more severe initial dysfunctions and worse outcome. Age over 60 years and initially more severe dysfunctions impacted the outcome. CONCLUSION:Patients with benign and malignant parotid neoplasms had significant and equivalent improvement in postoperative facial dysfunction following an early tailored physiotherapy program, with no significant difference in the final facial score, treatment duration, or number of sessions required.
