QUESTION: What is the effect of mime therapy on facial symmetry and severity of 
paresis in people with facial nerve paresis?
DESIGN: Randomised controlled trial.
PARTICIPANTS: 50 people recruited from the Outpatient department of two 
metropolitan hospitals with facial nerve paresis for more than nine months.
INTERVENTION: The experimental group received three months of mime therapy 
consisting of massage, relaxation, inhibition of synkinesis, and co-ordination 
and emotional expression exercises. The control group was placed on a waiting 
list.
OUTCOME MEASURES: Assessments were made on admission to the trial and three 
months later by a measurer blinded to group allocation. Facial symmetry was 
measured using the Sunnybrook Facial Grading System. Severity of paresis was 
measured using the House-Brackmann Facial Grading System.
RESULTS: After three months of mime therapy, the experimental group had improved 
their facial symmetry by 20.4 points (95% CI 10.4 to 30.4) on the Sunnybrook 
Facial Grading System compared with the control group. In addition, the 
experimental group had reduced the severity of their paresis by 0.6 grade (95% 
CI 0.1 to 1.1) on the House-Brackmann Facial Grading System compared with the 
control group. These effects were independent of age, sex, and duration of 
paresis.
CONCLUSION: Mime therapy improves facial symmetry and reduces the severity of 
paresis in people with facial nerve paresis.