Impact of Early Trismus Intervention Following Facial Nerve Palsy Reconstruction.

Abstract

Tensor fascia lata (TFL) slings are widely used in facial nerve reconstruction (FNR) to restore symmetry and tone, but postoperative trismus is a significant morbidity. This study assessed the feasibility of early rehabilitation using Restorabite, a novel force-controlled trismus device. Twenty-seven patients undergoing FNR with TFL slings commenced 10 weeks of Restorabite therapy a mean 1.3 ± 1.2 weeks postoperatively. Outcomes included maximal incisal opening (MIO) and trismus-related quality of life (Gothenburg Trismus Questionnaire, GTQ). Mean MIO improved by 13.0 mm (95% CI 11.0-15.0; p < 0.001), with 16 patients improving in trismus severity and 8 no longer meeting trismus criteria (> 35 mm). GTQ scores improved by 17.6 (95% CI 15.4-19.7; p = 0.02), particularly in eating and pain. Benefits were sustained at 6 and 12 months. Radiotherapy was associated with poorer outcomes. Early use of Restorabite is safe and effective for trismus rehabilitation following FNR with TFL slings.