Facial synkinesis outcome measures: A systematic review of the available grading systems and a Delphi study to identify the steps towards a consensus

Berner, Juan Enrique; Kamalathevan, Pragash; Kyriazidis, Ioannis; Nduka, Charles

doi:10.1016/j.bjps.2019.03.011

Cited by 21 publications

(18 citation statements)

References 25 publications

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“…Previously, it has been observed that there are no published studies on intraobserver reliability of FNGS [20]. Based on the results acquired from this and the previous studies [20,25], we suggest that of these three grading scales, SB should be the one recommended to be used.…”

Section: Gradingmentioning

confidence: 54%

“…Based on the results acquired from this and the previous studies [ 20 , 25 ], we suggest that of these three grading scales, SB should be the one recommended to be used.…”

Section: Discussionmentioning

confidence: 69%

“…The Sunnybrook facial grading system (SB) [ 23 , 24 ], on the other hand, seems to have grown in popularity amongst investigators [ 20 , 25 ]. It is a regional weighted system, that takes into consideration the resting symmetry of the face, the degree of voluntary movement, and also synkineses regionally.…”

Section: Introductionmentioning

confidence: 99%

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Ramsay Hunt syndrome: long-term facial palsy outcome assessed face-to-face by three different grading scales and compared to patient self-assessment

Kanerva

Jones

Pitkäranta

2020

Eur Arch Otorhinolaryngol

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Purpose To determine the long-term facial palsy outcome of Ramsay Hunt Syndrome by face-to-face grading by House-Brackmann Grading System, Facial Nerve Grading System 2.0, and Sunnybrook Facial Grading System concomitantly. To compare the applicability of the grading scales. To compare patients' self-assessed facial palsy outcome results to gradings performed by the investigator. To compare the face-to-face assessed facial palsy outcome to the initial palsy grade. Methods Fifty-seven patients self-assessed their facial palsy outcome and came to a one-time follow-up visit. The palsy outcome was graded by one investigator using the three above-mentioned grading systems concomitantly. The median time from syndrome onset to follow-up visit was 6.6 years. Result A good long-term face-to-face assessed palsy outcome was enjoyed by 84% of the patients. Trying to assess only one House-Brackmann grade to represent the palsy outcome was impossible for most patients. Facial Nerve Grading System 2.0 worked better, but needed adjustments and certain sequelae findings needed to be neglected for it to be executable. The Sunnybrook system worked the best. Nearly 20% of the patients assessed themselves differently from the investigator: both better and worse. Conclusion The Sunnybrook scale was the most applicable system used. With antiviral medication, the outcome of facial palsy in Ramsay Hunt syndrome starts to resemble that of Bell's palsy and emphasizes the importance of recognizing the syndrome and treating it accordingly. The results give hope to patients instead of the gloomy prospects that have stigmatized the syndrome.

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Section: Gradingmentioning

confidence: 54%

“…Based on the results acquired from this and the previous studies [ 20 , 25 ], we suggest that of these three grading scales, SB should be the one recommended to be used.…”

Section: Discussionmentioning

confidence: 69%

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Ramsay Hunt syndrome: long-term facial palsy outcome assessed face-to-face by three different grading scales and compared to patient self-assessment

Kanerva

Jones

Pitkäranta

2020

Eur Arch Otorhinolaryngol

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“…We use as standard in facial plastic clinic the Sunnybrook Facial Grading System. 9,10 We registered sex, age, original issue, evolution, and complications in all cases. Physical examination, photographs, video, satisfaction questionnaires, and spontaneous movement were carefully recorded and discussed at 1, 3, 6, and 12 months.…”

Section: Case Seriesmentioning

confidence: 99%

Inveterated Facial Palsy Correction with Endoscopically Assisted Multiple Muscle Transposition and Lifts: The EMTL Procedure

Borsetti

Gangemi

Germano

et al. 2020

Indian J Plast Surg

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Introduction The aim of the present analysis was to study the safety and efficacy associated with reanimation in facial nerve palsy by the endoscopically assisted multiple muscle transposition and lifts (EMTL). Patients and Methods The study sample included all patients who had undergone a facial reanimation by EMTL procedure from September 2015 to May 2019. The patients were analyzed retrospectively, with more than 1 year of follow-up, and were evaluated in terms of functional-aesthetic results and postoperative complications. The outcome was evaluated with the Sunnybrook scale. Results Fourteen patients were included in the present study. They were all inveterate palsies with minimum 4 years from the initial injury. The preoperative Sunnybrook score ranged from 0 to 5 and the postoperative ranged from 30 to 65. Spontaneous smile achievement was obtained in 10 patients and only mild restoration in one patient. The scar and static correction were satisfactory in all patients. Eye protection was improved in all cases with some form of active blinking in six cases. Conclusion This study showed that facial palsy correction with EMTL procedure offers a promising alternative treatment for patients with facial palsy not suitable for microsurgical muscle transposition.

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“…Synkinesis represents unwanted contraction of the muscles of the face during attempted movement, caused by aberrant reinnervation. Commonly, patients notice forceful eye closure when they attempt to smile, or other muscle spasms during routine facial movements [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Advanced Statistical Analysis of 3D Kinect Data: Mimetic Muscle Rehabilitation Following Head and Neck Surgeries Causing Facial Paresis

Kohout

Verešpejová

Kříž

et al. 2020

Sensors

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An advanced statistical analysis of patients’ faces after specific surgical procedures that temporarily negatively affect the patient’s mimetic muscles is presented. For effective planning of rehabilitation, which typically lasts several months, it is crucial to correctly evaluate the improvement of the mimetic muscle function. The current way of describing the development of rehabilitation depends on the subjective opinion and expertise of the clinician and is not very precise concerning when the most common classification (House–Brackmann scale) is used. Our system is based on a stereovision Kinect camera and an advanced mathematical approach that objectively quantifies the mimetic muscle function independently of the clinician’s opinion. To effectively deal with the complexity of the 3D camera input data and uncertainty of the evaluation process, we designed a three-stage data-analytic procedure combining the calculation of indicators determined by clinicians with advanced statistical methods including functional data analysis and ordinal (multiple) logistic regression. We worked with a dataset of 93 distinct patients and 122 sets of measurements. In comparison to the classification with the House–Brackmann scale the developed system is able to automatically monitor reinnervation of mimetic muscles giving us opportunity to discriminate even small improvements during the course of rehabilitation.

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Facial synkinesis outcome measures: A systematic review of the available grading systems and a Delphi study to identify the steps towards a consensus

Cited by 21 publications

References 25 publications

Ramsay Hunt syndrome: long-term facial palsy outcome assessed face-to-face by three different grading scales and compared to patient self-assessment

Ramsay Hunt syndrome: long-term facial palsy outcome assessed face-to-face by three different grading scales and compared to patient self-assessment

Inveterated Facial Palsy Correction with Endoscopically Assisted Multiple Muscle Transposition and Lifts: The EMTL Procedure

Advanced Statistical Analysis of 3D Kinect Data: Mimetic Muscle Rehabilitation Following Head and Neck Surgeries Causing Facial Paresis

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