A 25-Year Bibliometric and Scientometric Analysis of Facial Paralysis Rehabilitation: Knowledge Structure, Influential Works, and Emerging Research Frontiers (2000–2025)

Abstract

Background

Facial paralysis rehabilitation has progressed substantially over the past two decades, yet the scientific landscape of this field remains highly fragmented across surgical, neurological, and rehabilitation disciplines. Despite growing clinical and technological advances—including neuromuscular retraining, chemodenervation strategies, nerve transfer techniques, and artificial intelligence-assisted assessment—no comprehensive bibliometric synthesis has mapped the intellectual structure, global research trends, or emerging fronts of facial paralysis rehabilitation.

Methods

A bibliometric and scientometric analysis was conducted using the Web of Science Core Collection (SCI-E, SSCI, ESCI) covering the period 2000–2025. A total of 1441 publications were analyzed using Bibliometrix/R, VOSviewer, and CiteSpace. Performance indicators, collaboration networks, co-authorship and co-citation structures, keyword co-occurrence clusters, thematic evolution, and citation burst patterns were examined.

Results

Scientific output increased markedly, with an annual growth rate of 12.26% and a major acceleration after 2016. The United States dominated publication volume (n = 990), followed by Italy and China, while Harvard University and Massachusetts Eye and Ear emerged as the central institutional hubs. Hadlock TA represented the most influential author based on productivity and local citation impact. Source analysis demonstrated that Plastic and Reconstructive Surgery, Laryngoscope, and Otolaryngology–Head and Neck Surgery formed the journal core. Keyword and thematic analyses identified four major conceptual clusters: (1) rehabilitation and patient-centered outcomes, (2) surgical and reconstructive techniques, (3) synkinesis and chemodenervation, and (4) etiology and clinical assessment. Recent thematic fronts highlighted rapid expansion in artificial intelligence–based facial analysis, motion tracking systems, neuroplasticity-informed rehabilitation, and quality of life research. Citation burst detection revealed shifting priorities from early Bell's palsy management to contemporary technological and neurorehabilitation paradigms.

Conclusions

Facial paralysis rehabilitation has evolved into a multidisciplinary and rapidly expanding field driven by innovations in surgical reanimation, neuroplasticity-based therapy, and computational assessment. However, research output remains geographically concentrated, international collaboration rates are modest, and high-quality comparative effectiveness trials are limited. Future priorities include global research capacity building, standardized outcome measurement, long-term follow-up studies, and real-world evaluation of technology-assisted interventions.