Recovering Facial Function 18 Months Post Vestibular Schwannoma Excision: A Neuro-Rehabilitative Case Study

Author(s): Sanlap Kundu, Sarasij Bit, Patralika Nath  

Introduction: Vestibular schwannoma, or acoustic neuroma, is a benign tumor that affects the eighth cranial nerve, which often results in hearing loss, tinnitus, and balance issues. Surgical removal can lead to post-operative complications such as facial nerve palsy that can significantly impact a patient's quality of life.
Case description: This case study presents the rehabilitation of a 51-year-old female who developed right-sided facial palsy following a right retromastoid suboccipital craniotomy. Eighteen months post-surgery, she sought rehabilitation with complaints of facial asymmetry, difficulty in speech, chewing, swallowing, and incomplete eye closure.
Intervention: A tailored rehabilitation program was implemented, which included neuromuscular re-education, facial PNF exercises, mirror biofeedback, faradic stimulation, facial taping, and postural care. The patient also received interventions for tremor management and lower limb strengthening.
Outcome: Within four weeks, she demonstrated improvements in facial symmetry, eye closure and functional facial expressions, which was also evidenced by improved scores on the Sunnybrook Facial Grading System.
Conclusion: This case highlights the effectiveness of targeted physiotherapy in post-surgical facial palsy rehabilitation after the removal of vestibular schwannoma. A multidisciplinary approach that combines neuromuscular re-education, electrotherapy, and functional training can accelerate recovery and enhance the patient’s overall quality of life.