Mime therapy improves facial symmetry in people with long-term facial nerve paresis: a randomised controlled trial.

QUESTION What is the effect of mime therapy on facial symmetry and severity of paresis in people with facial nerve paresis? DESIGN Randomised controlled trial. PARTICIPANTS 50 people recruited from the Outpatient department of two metropolitan hospitals with facial nerve paresis for more than nine months. INTERVENTION The experimental group received three months of mime therapy consisting of massage, relaxation, inhibition of synkinesis, and co-ordination and emotional expression exercises. The control group was placed on a waiting list. OUTCOME MEASURES Assessments were made on admission to the trial and three months later by a measurer blinded to group allocation. Facial symmetry was measured using the Sunnybrook Facial Grading System. Severity of paresis was measured using the House-Brackmann Facial Grading System. RESULTS After three months of mime therapy, the experimental group had improved their facial symmetry by 20.4 points (95% CI 10.4 to 30.4) on the Sunnybrook Facial Grading System compared with the control group. In addition, the experimental group had reduced the severity of their paresis by 0.6 grade (95% CI 0.1 to 1.1) on the House-Brackmann Facial Grading System compared with the control group. These effects were independent of age, sex, and duration of paresis. CONCLUSION Mime therapy improves facial symmetry and reduces the severity of paresis in people with facial nerve paresis.