Course “Phonokinesic approach to facial

paralysis”
FONOHABILITA Foundation
EVALUATION PROTOCOL IN FACIAL PARALYSIS
(J. Hair, P. Moya, J. Muñoz, L. Ortega, C. Roland)

YO. Personal history:

Name: _________________________________________________________________________
Age: ______________ Date of birth.: ___ /___ /___ Assessment: ___ /___ /___
Carer: ________________________________ Relationship: ____________________________
Medical diagnostic: ____________________________________________________________
Speech therapy diagnosis: _____________________________________________________
Previous speech therapy treatment: Yes □ / No□
Do you take any medication for facial paralysis? Yes□ / No □
Which?: ________________________________________________________________________

II. Relevant medical history:

HTA Yes □ / No Allergies Yes □ / No□
•
DM Yes □ / No stroke Yes □ / No□
•
Herpes Yes □ / No Aneurysm Yes □ / No□
•
meningeal infection Yes □ / No Stress – depression Yes □ / No□
•
Others: ________________________________________________________________________

III. Facial Symmetry:

Repose: Action:

Symmetrical Asymmetric Symmetrical Asymmetric

Eye
W
Eye

Mouth Mouth
 Course “Phonokinesic approach to facial
paralysis”
FONOHABILITA Foundation

IV. Pain points:

Spot pain scale

Hallway under the wing of the nose ①②③④⑤⑥⑦⑧⑨⑩

Muscle of the wing of the nose ①②③④⑤⑥⑦⑧⑨⑩

ATM ①②③④⑤⑥⑦⑧⑨⑩

Mastoid ①②③④⑤⑥⑦⑧⑨⑩

v. Speech therapy evaluation:

1. Sensitivity:

Present diminished Absent Observations

EXTRAORAL

Right unilateral

Left unilateral
INTRAORAL

Right unilateral

Left unilateral

Sweet taste
LINGUAL

Salty flavor

2
 Course “Phonokinesic approach to facial
PHONOHABILI
FOUNDATION paralysis”
TA FONOHABILITA Foundation
REHABILITATION. HEALTH AND MOVEMENT

2. HOW:
Muscles Disturbance
Lip BLF Moves
involved Right. Left Observations
Orbicularis oris, Yes □ Yes □
compressor and No □ \ No□ \
risorium
Pucker and stretch lips
(showing teeth)
Orbicularis oris Yes □ Yes □
and compressor No □ \ No □ \

vibrate lips
Orbicularis oris, Yes □ Yes □
compressor and No □ \ No□ \
risorium

Smile
Orbicularis oris Yes □ Yes □
and compressor No □ \ No □ \

1
soup
Yes □ Yes □ No
msaon 1 Upper : middle No□ □
-lé A • -
fibers of the
MMh
Genioglossus
Tip on upper/lower teeth
and upper
lingual Lower :
Upper fibers of
the Genioglossus
and lower lingual
risorio Yes □ Yes □
No □ \ No □ \

N€ ' 1
Move lip corner to right/left

3
 Course “Phonokinesic approach to facial
PHONOHABILI
FOUNDATION paralysis”
TA FONOHABILITA Foundation
REHABILITATION. HEALTH AND MOVEMENT

%5" Orbicularis oris Yeah Yeah

• •
F
and compressor

lip smack
\ \
Orbicularis oris Yes □ Yes □
and compressor No No

• •
Nibbling upper/lower lip \ \
Muscles Disturbance
BLF facial movements
involved Right. Left Observations
Buccinator, Yeah Yes □
major
zygomaticus and • • No

Puff both cheeks

minor
zygomaticus \ \
Buccinator, NoYeah Yeah
major
zygomaticus and • •
Puff out cheeks
alternately
minor
zygomaticus
No
\ \ No
Nasal dilator, Yeah Yeah
canine and
levator labii • •
Turn up your nose superioris
Occipitofrontal
\ \
Yes □ Yes □
No No

• •
Raise both eyebrows
Ciliary \ \
Yeah Yeah

• •
Bring your eyebrows
together \ \
4
 Course “Phonokinesic approach to facial
PHONOHABILI paralysis”
TA
FOUNDATION FONOHABILITA Foundation
REHABILITATION. HEALTH AND MOVEMENT

Yeah • Yeah •
Orbicularis No • No •
oculi

Close the eyes

Myrtiform, Yes □ Yes □
square beard No No
and beard tassel • •

Wrinkle the chin

Disturbance
Lingual BLF movements Muscles involved
Right. Left Observations
Yeah •
Middle fibers of No • Yes □
the genioglossus No
•
stick out your tongue
Yeah • Yeah •
No • No •
Pharynglossus,
Hyoglossus and
upper fibers of
enter the tongue the genioglossus
Styloglossus, Yes □ Yes □
amygdaloglossu No No
• •
s and upper
Tongue cap lingual
Yeah • Yeah •
Transverse of No • No •
the tongue

fold the tongue

Middle fibers of Yes □ Yes □
the genioglossus No No
• •

Push cheek to right/left

5
 Course “Phonokinesic approach to facial
paralysis”
FONOHABILITA Foundation

Medium fibers Yes □ Yes □

of the No□ No□
geniusglossus
Upper and lower and lingual
labial vestibules superior and
lower

3. Swallowing

Present Altered Absent Observations

lip closure

lingual
movements
Pharyngeal
elevation

Suction

Rotary jaw
movements

Oral-facial tone

Oral preparatory
stage

6
 Course “Phonokinesic approach to facial
paralysis”
FONOHABILITA Foundation

4. Articulatory sweep
Phonemes b p m F d t yes n l r ř and ņ ĉ k g x
ia ie io iu ua EU ui wowai ouc hey eu I ae year eo eah oa
Diff. vowels hdecreasing hea
growing Diphthongs
pl bl fl gl tl cl Note:
Diff. with L/
Diff. with pr br fr gr tr cr dr
/r/
Trabantes yes l n m r p k

5. Communication impairment:

6. Diagnostic Hypothesis:

Name and Signature of Evaluator