Weeks after diagnosis

House Brackmann grade13

Strength of facial muscle (Z, T, P, F, G, N)*

Functional improvement report per patient**

Frontalis

Zygomaticus major

Orbicularis oris

Depressor anguli

9

V

Z

T

T

T

Difficulty seeing entire eye lash, able to say “p”, “b”, “m”, and “f” with effort.

10-11

V

T

T

T

T

Able to say the word “door” without spittle, notes feeling “smiling” muscles more consistently

12

V-IV

T

T

T

T

Wishes for change in treatment for home use to “increase” facial muscles (start of Kinesio Tex® tape instruction).

13-14

IV

P

P

P

P

New tingling sensation around eye and now able to take large bites of food, still majority of chewing left sided.

17-19

III

F

F

F

F

Able to close eye with forceful wink consistently, at week 19 able to perform reciprocal blinking first time since onset – does note eye watery at times

22

III-II

F

F

F

F

Now able to say “fifty-five thousand” without excess sounds or spittle. Feels 75-80% back to full recovery.

41-48

III-II

G

F

G

G

Now able to apply eyeliner and lipstick without difficulty.  Denies difficulty with extra sounds when speaking for work as teacher. Concerns regarding hypertrophy of left side and pulling mouth over with speaking – now limiting left side with tape and increase stretching. 

53-66

II

N

G

G

N

Synkinesis starting to become more noticeable, HEP not being performed routinely due to busy work schedule.  Tugging, not pain reported – better with platysma stretch.  Feels after blocking abnormal movement and performing isolated facial expression facial symmetry improved.

73

II

N

G

G

N

Able to drink out of bottle of water without difficulty, feels 95+/- 2% back to full recovery. Following up with primary physician due to recent death in family and diabetes in need of regulation.  Watery eye and synkinesis increases with stress and fatigue, but rare and variable.

* Z = zero, T= trace, P= poor, F= fair, G = good, N= normal6
**Statements taken directly from documentation as per patient report at respective visit
Table 3: Outcomes of House Brackmann grade, strength, and subjective findings per week.