{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:49:06Z","timestamp":1790639346777,"version":"4.1.0"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,9,30]],"date-time":"2011-09-30T00:00:00Z","timestamp":1317340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The efficacy of facial biofeedback rehabilitation with a mirror after administration of a single dose of botulinum A toxin on facial synkinesis was examined in patients with chronic facial palsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective clinical study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>University hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>The present study includes 8 patients with Bell palsy and 5 with herpes zoster oticus showing facial synkinesis. A single dose of botulinum A toxin was used as the initial process of facial rehabilitation. Patients then continued a daily facial biofeedback rehabilitation with a mirror at home. They were instructed to keep their eyes symmetrically open using a mirror during mouth movements. The degree of oral\u2010ocular synkinesis was evaluated by the degree of asymmetry of eye opening width during mouth movements (% eye opening).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After administration of a single dose of botulinum A toxin, temporary relief of facial synkinesis was observed in all patients. Patients were then instructed to continue the facial biofeedback rehabilitation with a mirror for 10\u00a0months. The mean values of the percent of eye opening during 3 designated mouth movements that included lip pursing \/u:\/, teeth baring \/i:\/, and cheek puffing \/pu:\/ increased significantly after 10\u00a0months when the effects of botulinum A toxin had completely disappeared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These findings demonstrate that facial biofeedback rehabilitation with a mirror after administration of a single dose of botulinum A toxin is a long\u2010lasting treatment of established facial synkinesis in patients with chronic facial palsy.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599811424125","type":"journal-article","created":{"date-parts":[[2011,9,30]],"date-time":"2011-09-30T23:08:54Z","timestamp":1317424134000},"page":"40-45","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":65,"title":["Mirror Biofeedback Rehabilitation after Administration of Single\u2010Dose Botulinum Toxin for Treatment of Facial Synkinesis"],"prefix":"10.1002","volume":"146","author":[{"given":"Takahiro","family":"Azuma","sequence":"first","affiliation":[{"name":"Department of Otolaryngology University of Tokushima School of Medicine Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuhiko","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Tokushima School of Medicine Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Tokushima School of Medicine Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seizo","family":"Ohyama","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Tokushima Prefectural Central Hospital Tokushima 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