Recovery of facial expressions using functional electrical stimulation after full-face transplantation.
Çağdaş Topçu, Hilmi Uysal, Ömer Özkan and 7 others
PMID 29510722WHAT IT FOUND
Two face transplant patients showed improved facial muscle symmetry and reduced synkinesis after 5 months of individualized functional electrical stimulation.
The treatment combined stimulation with visual feedback and peer modeling, but without a control group, it is unclear if reinnervation alone caused the changes.
Key findings
01Synkinesis was eliminated for the lid tightening movement in Patient A after rehabilitation.
02Patients showed improved symmetry and similarity to healthy controls in primary facial movements and emotional expressions after 5 months of therapy.
03The rehabilitation protocol combined electrical stimulation, visual feedback of the patient's own face, and concurrent movement by a healthy peer.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Only two patients were studied, with no control group receiving standard care or no treatment. It is impossible to separate the effects of the FES intervention from natural, ongoing reinnervation that occurs months or years after transplantation. Synkinesis persisted in several muscle groups despite treatment. The study relies on sEMG complexity measures rather than standardized clinical outcome scales for facial function.
Declared interests
Funded by the Scientific and Technological Research Council of Turkey (TUBITAK). No other conflicts of interest are declared.
The easy way to misread this
Do not assume the electrical stimulation caused the recovery. These patients were 33 and 37 months post-transplant, a period when natural nerve regeneration and reinnervation are still occurring. Without a control group, the improvements could be due to the passage of time rather than the therapy.