How to Enhance the Success of Selective Neurectomy for Facial Synkinesis by Considering the Patient's Preferences: Lesson Learned from a Retrospective Analysis of 122 Cases

Park, Tae Hwan; Park, Il Seok; Kim, Jin

doi:10.1007/s00266-023-03620-8

Cited by 4 publications

(3 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The findings demonstrate that selective neurectomy provides satisfactory outcome regarding facial tightness as well as narrowing of the eyelid aperture and improves the vertical inclination of the corner of the mouth, however, the improvement of the horizontal angles remain suboptimal. 60 Currently, there is limited reporting regarding the longevity of these surgical interventions. van Veen et al demonstrated that, although patients undergoing selective neurectomy for periocular synkinesis usually experience a symptom-free interval after the surgery, most required renewed BTX-A treatment later on.…”

Section: Surgerymentioning

confidence: 99%

“…Secondly, these are usually patients that have exhausted or failed conservative treatments such as BTX-A or facial rehabilitation. 60 Selective chemodenervation with botulinum toxin and facial therapy remain the cornerstones in the treatment of PPFS. BTX-A offers patients a quick symptomatic improvement, reduction of synkinesis, and overall symmetrization of the face.…”

Section: Limitations Challenges and Prospectsmentioning

confidence: 99%

See 1 more Smart Citation

Approaches to the Management of Synkinesis: A Scoping Review

Zubler,

Punreddy,

Mayorga-Young

et al. 2024

Facial Plast Surg

View full text Add to dashboard Cite

Post-paralysis facial synkinesis can develop in any facial palsy and is associated with significant functional and psychosocial consequences for affected patients. While the prevention of synkinesis especially after Bell’s Palsy has been well examined, much less evidence exists regarding the management of patients with already established synkinesis. Therefore, the purpose of this review is to summarize the available literature and to provide an overview of the current therapeutic options for facial palsy patients with established synkinesis. A systematic literature review was undertaken, following the PRISMA 2020 guidelines. MEDLINE via PubMed and Cochrane Library were searched using the following strategy: ((facial palsy) OR (facial paralysis) OR (facial paresis)) AND (synkinesis) AND ((management) OR (guidelines) OR (treatment)). The initial search yielded 201 articles of which 36 original papers and 2 meta-analyses met the criteria for inclusion. Overall, the included articles provided original outcome data on 1408 patients. Articles were divided into the following treatment categories: chemodenervation (12 studies, 536 patients), facial therapy (5 studies, 206 patients), surgical (10 studies, 389 patients) and combination therapy (9 studies, 278 patients). Results are analyzed and discussed accordingly. Significant heterogeneity in study population and design, lack of control groups, differences in postoperative follow-up as well as the use of a variety of subjective and objective assessment tools to quantify synkinesis prevent direct comparison between treatment modalities. To date there is no consensus on how post-paralysis facial synkinesis is best treated. The lack of comparative studies and standardized outcome reporting hinder our understanding of this complex condition. Until higher-quality scientific evidence is available, it remains a challenge best approached in an interdisciplinary team. An individualized multimodal therapeutic concept consisting of facial therapy, chemodenervation and surgery should be tailored to meet the specific needs of the patient.

show abstract

Section: Surgerymentioning

confidence: 99%

Section: Limitations Challenges and Prospectsmentioning

confidence: 99%

Approaches to the Management of Synkinesis: A Scoping Review

Zubler,

Punreddy,

Mayorga-Young

et al. 2024

Facial Plast Surg

View full text Add to dashboard Cite

show abstract

“…The authors concluded that selective neurectomy can effectively address concerns related to facial tightness and narrowing of the eyelid aperture. It can significantly enhance the upward movement of the mouth corners, although the improvement in horizontal angles may not be as optimal [43]. Chuang et al's study aimed to present proof that this surgical approach is successful in treating synkinesis and improving the quality of smiles.…”

Section: Additional Findingsmentioning

confidence: 99%

Facial Paralysis Treatment Using Selective Neurectomy: A Comprehensive Review

Fatani,

Alshalawi,

Alsuhaibani

et al. 2024

Cureus

View full text Add to dashboard Cite

Facial paralysis can affect patients undergoing full mouth rehabilitation, regardless of what caused their paralysis. A procedure known as modified selective neurectomy of the facial nerve can enhance the movement of facial muscles in individuals with facial synkinesis safely and effectively. This approach is proposed as an alternative to more invasive surgical options when used independently as a treatment for incomplete facial palsy. Selective neurectomy offers a promising surgical option for managing nonflaccid facial paralysis and synkinesis, enhancing patients' quality of life. However, treatment plans should be individually tailored considering the complexity of facial paralysis and the unique needs of each patient, taking into account the timing and type of treatment. The objective of this review is to explore the use of selective neurectomy as a treatment for facial paralysis based on previously published papers.

show abstract