The Application of Polydioxanone Thread Implantation in Rehabilitating Sequelae of Idiopathic Peripheral Facial Paralysis

Abstract

Background: Idiopathic peripheral facial paralysis often leads to chronic facial motor deficits in 30% of patients, significantly impacting their quality of life. Current treatment options for the chronic phase are limited. Polydioxanone (PDO) thread embedding has shown promise in improving facial disability in these patients, but evidence is scarce.
Objective: This study aimed to evaluate the effectiveness and safety of PDO thread embedding in improving facial motor function in patients with chronic idiopathic peripheral facial paralysis.
Methods: In this prospective clinical trial, 39 patients with chronic idiopathic peripheral facial paralysis (≥3 months) and Facial Disability Index (FDI) scores indicating significant impairment were enrolled. Patients received weekly PDO thread embedding sessions for 6 weeks, with 10 threads per session. The primary outcome was the change in FDI scores after 6 weeks. Secondary outcomes included changes in House-Brackmann grading (HB Gr), the proportion of patients achieving effective improvement in facial motor function, and adverse events.
Results: Of the 33 patients who completed the study, the mean total FDI score improved significantly from 88.30 ± 22.05 to 155.45 ± 18.39 (p < 0.001). Both physical and social components of the FDI showed significant improvements (p < 0.001). The proportion of patients with HB Gr IV decreased from 60.60% to 0%, with 42.40% achieving HB Gr II. Effective improvement in facial motor function was observed in 60.60% of patients. Adverse events were mild and self-resolving, including bleeding (66.70%), swelling (45.50%), and bruising (24.20%).
Conclusion: PDO thread embedding is a safe and effective intervention for improving facial motor function in patients with chronic idiopathic peripheral facial paralysis.