Lower lip-lifting brace for bilateral facial nerve palsy: a case report

A 55-year-old man suffered from pontine hemorrhage 5 years before he visited our outpatient clinic with complaints of gait disturbance and dysphagia. At the first examination, his inability to close his mouth, eyes, and lower lip led to the diagnosis of facial diplegia. He was instructed to wear a gauze surgical mask and to use artificial saliva for his xerostomia. A videofluorogram of his swallowing excluded aspiration but revealed dysphagia attributable to neck hyperextension arising from efforts to prevent food spilling from his mouth. We prescribed a brace to lift his lower lip as a treatment of his dysphagia. This brace covered his chin to support his lower lip. Our brace resulted in improved function; liquids no longer leaked from his mouth and because the lip elevation eliminated his xerostomia, he no longer required artificial saliva or the gauze mask.