1000 Section - Effects of OnabotulinumtoxinA Application to the Healthy Side of the Face Plus Conventional Rehabilitation in Individuals with Acute Peripheral Facial Paralysis

Idiopathic peripheral facial paralysis(IPFP) affects quality of life due to its impact on the patient's social interaction(1). Initial treatment is limited(2), evidence suggests that injecting botulinum-toxin into the healthy side of the face can improve recovery time, quality of life, and functionality(3-6).

To compare the effects of rehabilitation alone versus the addition of onabotulinumtoxinA application to the healthy side of the face on the severity, functionality, and well-being of patients with IPFP.

Design:

A quasi-experimental study was conducted on 15-patients with acute IPFP(House-Brackmann [HBs] score >II) at the rehabilitation unit of HGR1-IMSS-Yucatán,Mexico. The study was authorized by ethics/research committee(R-2024-3201-099), period September-December/2024. Two groups were randomly formed: control group(rehabilitation) with 8 patients and toxin group(rehabilitation+toxin) with 7-patients. Both groups completed a clinical-sociodemographic questionnaire and the Facial Disability Index(FDI). The control group received 10 sessions of conventional rehabilitation. The toxin group received onabotulinumtoxinA injections of up to 16U(2U/point) in the muscles of the unaffected side of the face, diluted 1:1 with physiological saline. HBs levels were monitored for reduction and FDI scores 2-4weeks post-application. Data processing, descriptive and inferential statistics were performed using SPSS.

Results:

The predominant clinical and sociodemographic characteristics were male sex(10,66.7%), mean age 43.07±12.97years, and metabolic comorbidities(8,53.3%). After four weeks of treatment, patients in the toxin group showed a decrease of >3 points in HBs in 4(57.1%)vs.0(0%) patients in the control group(p< 0.05). A similar trend toward improvement was observed in IDF scores at four weeks post-intervention; physical function scores were x̄60.71±15.6vs.x̄50.71±15.1(baseline), x̄81.4±21.7vs.x̄74.8±22.6(2-weeks), and x̄83.5±17.4vs.x̄83.1±28.1(4-weeks)(p >0.05). Social function and well-being: x̄26.2±8.2vsx̄36.00±13.6(baseline), x̄30.2±14.2vsx̄37.5±21.2(2-weeks), and x̄24.5±18.2vsx̄27.0±17.0(4-weeks)(p >0.05).

Conclusion:

This study suggests that early application of onabotulinumtoxinA to the unaffected side of patients with IPFP undergoing conventional rehabilitation reduces severity and improves physical and social functioning and well-being at 4-weeks post-application. Further studies with more participants are needed to strengthen this assertion.