Long-term rehabilitation of traumatic peripheral facial paralysis using an oral proprioceptive hyperboloid protocol: a 12-year case report

Traumatic peripheral facial paralysis is a disabling condition that may compromise facial expression, mastication, swallowing, speech, and quality of life. Although several rehabilitation approaches have been proposed, evidence regarding the long-term outcomes of oral proprioceptive stimulation remains limited. A 68-year-old man developed traumatic peripheral facial paralysis following surgery for a cerebellopontine angle tumor in 2003. After several unsuccessful rehabilitation attempts, a hyperboloid-based oral proprioceptive rehabilitation protocol was initiated in 2010. The patient performed intraoral exercises three times daily and underwent clinical follow-up for 12 years. Clinical improvement was first documented approximately 45 days after treatment initiation, with restoration of lip competence. Subsequent improvements included reduced drooling and liquid leakage, better mastication and oral bolus control, improved speech intelligibility and facial symmetry, and increased social participation. Functional gains were maintained throughout the long-term follow-up period with individualized maintenance exercises. This case describes sustained functional improvements observed during long-term follow-up after rehabilitation using a hyperboloid-based oral proprioceptive protocol. Although stimulation of the stomatognathic system may have contributed to the observed functional recovery, treatment effectiveness cannot be established from a single case. Further prospective studies using standardized outcome measures are needed to investigate the potential role of this therapeutic approach.