Facial synkinesis (FS) is a distressing sequela of facial palsy (FP) characterized by involuntary, simultaneous movements of facial muscles occurring during voluntary facial expressions. Treatment of synkinesis is challenging, and preventive methods are needed.

This study evaluates the efficacy of physical facial nerve rehabilitation (PFNR) therapy alone versus PNFR with eyelid surgery to correct lagophthalmos and prevent the onset of synkinesis.

25 outpatients are randomized to receive either PFNR alone (neuromuscular retraining and Kabat proprioceptive neuromuscular facilitation) or PNFR and early (90 days after FP onset) eyelid surgery (involving a conservative oculoplastic correction for lagophthalmos with epiphora or ectropion). Comprehensive otolaryngological assessments and Magnetic Resonance Imaging (MRI) will be conducted. Synkinesis progression was measured using Another Disease Scale (ADS) at baseline, 3 months 6 months, 12 months, and 24-months post-treatment. The data were analyzed with ANOVA, t-test, Chi-Square analyses.

Inclusion Criteria:

• people over 18 years old
• willingness to participate
• acute/new onset of FP (less than 15 days)

Exclusion Criteria:

• neuro-inflammatory diseases (e.g., Multiple Sclerosis)
• FP from systemic disorders (e.g., Guillain-Barré syndrome, Lyme disease, encephalitis)
• FP from middle ear infections or untreated cholesteatoma
• severe cognitive or psychological disorders
• non-consent to participate in the study

The data will be shared after data publication