Conteúdos psíquicos e efeitos sociais associados à paralisia facial periférica: abordagem fonoaudiológica / Psychological contents and social effects associated to peripheral facial paralysis: a speech-language approach

INTRODUÇÃO: A paralisia facial periférica (PFP) decorre da redução ou interrupção do transporte axonal ao sétimo nervo craniano resultando em paralisia completa ou parcial da mímica facial. A deformidade facial e a limitação de movimentos, além de prejudicar a estética e a funcionalidade, podem interferir significativamente na comunicação interpessoal. OBJETIVO: Investigar os conteúdos psíquicos e os efeitos sociais associados à PFP em sujeitos adultos, realizando uma análise comparativa em três grupos de sujeitos com PFP: nas fases flácida, de recuperação e sequelar. MÉTODO: Pesquisa de natureza clínico quanti-qualitativa. 16 sujeitos adultos, ambos os sexos, na faixa etária de 43 a 88 anos, com PFP. Procedimento: Entrevistas abertas com os sujeitos. O material foi gravado em áudio e vídeo, transcrito literalmente, sistematizado por meio de análise categorial e estatística. RESULTADOS: Os sujeitos portadores de sequelas apresentam maior significância estatística de conteúdos psíquicos e efeitos sociais associados à PFP. Seguidos, respectivamente, dos que se encontram nas fases flácida e de recuperação. Os resultados sugerem que o fonoaudiólogo, além de realizar a reabilitação funcional e estética do sujeito acometido pela PFP, precisa ter escuta para aspectos psíquicos e sociais envolvidos, de maneira a avaliar e buscar diminuir o grau de sofrimento psíquico e favorecer a adaptação social desses pacientes. CONCLUSÃO: A abordagem biopsicosocial dos pacientes acometidos pela PFP revelou vasta, e significativa, gama de conteúdos subjetivos que justificam novos estudos que possam contribuir para a eficácia do método clínico fonoaudiológico na abordagem desse quadro clínico. Palavras-chave Paralisia Facial, Paralisia de Bell, Estudos de Casos, Impacto Psicossocial.

INTRODUCTION: The peripheral facial paralysis (PFP) results from the reduction or interruption of the axonal transport to the seventh cranial nerve resulting in complete or partial paralysis of the facial movements. The facial deformity and limitation of movements, besides affecting the aesthetics and functionality, can significantly interfere with interpersonal communication. OBJECTIVE: Investigate the psychological contents and other social effects associated to PFP in adult subjects, performing a comparative analysis in three groups of subjects with PFP: at flaccid, recovery and sequel phases. METHOD: Quantitative and qualitative research. 16 adult subjects, from both sexes, aging between 43 and 88 years old, with PFP. PROCEDURE: Open interviews with subjects. The material was recorded in audio and video, literally transcribed, systematized through categorical and statistical analysis. RESULTS: The subjects bearing sequels presented higher statistical significance of psychological contents and social effects associated to PFP. Followed, respectively, by those that were on flaccid and recovery phases. The results suggest that the speech-language therapist, besides performing functional and aesthetical rehabilitation with the subject with PFP, needs to be aware of psychological and social aspects that may be involved, in order to evaluate and seek to reduce the degree of psychological distress and promote the social adjustment of these patients. CONCLUSION: The biopsychosocial approach to patients with PFP revealed a wide and significant range of subjective contents that warrant new studies that may contribute to the effectiveness of the speech-language clinical method to approach this medical condition.

A Case of Severe Bell Palsy Successfully Treated with Daisangoshichisanryo and Kososan during Pregnancy / 日本東洋医学雑誌

Generally, as for the Bell paralysis in facial nerve paralysis, about 70% are cured spontaneously, and, as for the remainder, steroid and antiviral agent (aciclovir) medical treatment are taken, but treatment of the Western medicine is invalid in the serious case. As a result, the paralysis remains and the aftereffects of the morbid synkinesis is caused. Finally, it becomes the result of greatly damaging QOL because of features of a peculiar face for the patient.The case is 29-year-old pregnant woman and primipara. Abnormality was not especially found in the previous history without what had to be mentioned specially while getting pregnant. A right paralysis of facial nerve developed suddenly cold early morning of 35 gestational weeks (paralysis score 0/40). She gave birth naturally without the effect though the steroid was treated by otorhinolaryngologist. After birth, Kampo treatments were begun with Kakkonto and Saireito for two months. Place where those medicines changed to Daisangoshichisanryo and Kososan because of invalidity, an eye closure and open eyes would become smooth in two weeks, and it recovered in almost one month. Here is a first reported case that concurrent Kampo therapy with Daisangoshichisanryo and Kososan were effective for patient with paralysis of facial nerve that developed during pregnancy.

Clinical Therapeutic Observation on Bell Paralysis Treated by Combined Therapy of Chinese and Western Medicine / 浙江中医药大学学报

[Objective]To explore the effect of combined therapy of Chinese and western medicine on Bell paralysis.[Methods] Randomly divide 62 cases of Bell paralysis into 2 groups who were treated respectively with combined therapy of Chinese and western medicine and western medicine.[Results] For effective rate,the treatment group(91.1%) was markedly higher than control group(67.8%),there was obvious difference between the 2 groups.[Conclusions] Combined therapy of Chinese and western medicine has marked therapeutic effect on Bell paralysis.