Manual Lymphatic Drainage with Facial Paralysis after Schwannoma: A Case Report

Margit Eidenberger

Abstract


Aim: Facial paralysis is a common complication after Schwannoma surgery. Neural edema can be one of the reasons. Manual Lymphatic Drainage is the most efficient therapy in resolving lymphedemas, but has to date not been tried for facial paralysis in conjunction with Schwannoma surgery. It was therefore the aim of this paper to try Manual Lymphatic Drainage.    
Materials and Methods: Case report of a 46-year old female Caucasian patient who has suffered from facial paralysis and intraoral seroma for one year after Schwannoma resection. Over that year, the facial paralysis showed a non-therapy-induced recovery of one degree on the House-Brackmann Facial Nerve Grading Scale. Three months prior to referral, a gold implant to facilitate eye closure was inserted in the upper eyelid. The patient suffered from eye region edema, redness in the eye region and conjunctiva, dry eye syndrome, a scraping feeling and glued eye. Conventional physiotherapy (facio-oral therapy, mimic exercises) showed no results. Six Manual Lymphatic Drainage treatments were performed. This led to a regression of the edema and the seroma after the first and the third therapy sessions, respectively. The facial paralysis improved by one degree (V-IV). As a consequence, the use of lubrication ointment could be reduced.                                                                                                                 Conclusion: Manual Lymphatic Drainage can be applied as an adjuvant therapy in Facial Paralysis and edema related to Schwannoma, which are not responsive to other therapies.


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