Surface electrical stimulation for facial paralysis is not harmful

Abstract

Introduction: Does electrical stimulation (ES) of denervated muscles delay or prevent reinnervation, or increase synkinesis? In this retrospective study we evaluate the outcome, with and without ES, of patients with acutely denervated facial muscles. Methods: The effect of ES was analyzed in two experiments. In the first experiment, 39 patients (6 with home-based ES, median 17.5 months) underwent facial nerve reconstruction surgery. Time to recovery of volitional movements was analyzed. The second experiment involved 13 patients (7 with ES, median 19 months) during spontaneous reinnervation. Sunnybrook and eFACE scores provided functional outcome measures. Results: No difference in time of reinnervation after facial nerve reconstruction surgery was seen between the patients with and without ES (median [interquartile range]: 4.5 [3.0-5.25] vs 5.7 [3.5-9.5] months; P =.2). After spontaneous reinnervation, less synkinesis was noted (Sunnybrook synkinesis score: 3.0 [2.0–3.0] vs 5.5 [4.75-7.0]; P =.02) with ES. Discussion: We find no evidence that ES prevents or delays reinnervation or increases synkinesis in facial paralysis.