PURPOSE: The purpose of this study is to investigate peculiar patterns of facial asymmetry following incomplete recovery from facial paralysis that require optimal physical therapy for effective facial rehabilitation, and to decrease the incidence of avoidable facial sequelae. MATERIALS AND METHODS: This study involved 41 patients who had facial sequelae following the treatment of various facial nerve diseases from March 2000 to March 2007. All patients with a follow-up of at least 1 year after the onset of facial paralysis or hyperactive function of the facial nerve were evaluated with the global and regional House-Brackmann (HB) grading systems. The mean global HB scores and regional HB scores with standard deviations were calculated. Other factors were also analyzed. RESULTS: Four patterns of facial asymmetry can be observed in patients with incomplete facial recovery. The most frequently deteriorated facial movement is frontal wrinkling, followed by an open mouth, smile, or lip pucker in patients with sequelae following facial nerve injury. The most common type of synkinesis was unintended eye closure with an effort to smile. CONCLUSION: We described common configurations of facial asymmetry seen in incomplete recovery following facial nerve injury in an attempt to develop an optimal strategy for physical therapy for complete and effective facial recovery, and to decrease the incidence of avoidable sequelae.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Face/physiopathology ; Facial Asymmetry/*physiopathology ; Facial Nerve/pathology ; Facial Nerve Injuries/physiopathology/therapy ; Facial Paralysis/physiopathology/*therapy ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Treatment Outcome

OBJECTIVETo investigate the effect of unilateral mastication on glenoid fossae by means of animal experiment.

METHODSAn animal model of unilateral mastication was established by extracting right mandibular molars of Wistar rats. The rats were sacrificed in different period to examine the location changes of glenoid fossae through sagittal and horizontal plane.

RESULTSThe anterior points of glenoid fossae in non-masticatory side of experimental groups were more anterior than those in masticatory sides. The anterior points of the glenoid fossae of non-masticatory sides in experimental groups were more anterior than those of the same sides in the control groups after inducing unilateral mastication for two and four months. After inducing unilateral mastication for two and four months, the anterior and the posterior points of the glenoid fossae of non-masticatory sides in experimental groups became closer to the midline by comparison with masticatory sides as well as the same sides in control groups. Locations of glenoid fossae in masticatory sides showed no changes in comparison with the same side of the control groups.

CONCLUSIONThe forward and inward remodeling of the glenoid fossae can be observed after unilateral mastication was induce to the non-masticatory sides of experimental rats. It is concluded that unilateral mastication might be one of the etiologic factor of temporomandibular joint disorders.

Alveolar Process ; growth & development ; pathology ; Animals ; Facial Asymmetry ; physiopathology ; Female ; Mandible ; growth & development ; pathology ; Mandibular Condyle ; growth & development ; pathology ; Mastication ; physiology ; Maxilla ; growth & development ; Maxillofacial Development ; physiology ; Rats ; Rats, Wistar ; Temporomandibular Joint ; growth & development ; pathology ; Temporomandibular Joint Disc ; physiopathology