Two‐step highly selective neurectomy for refractory periocular synkinesis

Etiology, diagnosis, and management of facial palsy: 2000 patients at a facial nerve center

“…) . For patients unsatisfied after conservative management, adjunctive procedures, such as platysmectomy and selective neurectomy may provide long‐term symptomatic relief …”

“…28,[30][31][32][33] For patients unsatisfied after conservative management, adjunctive procedures, such as platysmectomy and selective neurectomy may provide long-term symptomatic relief. 34,35 Surgical facial reanimation, which many patients and physicians view as the final step in the management of FP, is not a single procedure, but rather a process. Numerous surgical interventions have been employed, from static and dynamic reanimation to neural reconstruction.…”

Selective orbicularis neuromyectomy for postparetic periocular synkinesis

“…However, it can be difficult to achieve consistent results with this procedure because of the extensive anastomosis between the facial nerve branches. However, the selective neurectomy technique proposed by Hohman et al 8 is a possible solution to this problem because its effectiveness can be predicted by getting the patient to smile during the procedure. Myectomy involves the partial resection of the affected muscle group with the aim of ameliorating the synkinetic movement.…”

An Evidence-Based Approach to Facial Reanimation

“…Partial orbicularis oculi denervation via a 2-step highly selective neurectomy has been described in a small case series with good results (level IV). 132 Midface Suspension of the NLF and ENV in FFP restores midfacial balance at rest and improves nasal An Evidence-Based Approach to Facial Reanimation breathing. Using 3 strips of fascia lata to suspend the ENV, NLF, and oral commissure, Bhama and colleagues 133 demonstrated a significant improvement in patient-reported FaCE scores and temporally blinded expert assessment of midfacial appearance (MFA) on a 10-point Likert scale between preoperative and postoperative periods (FaCE 45 AE 16 vs 58 AE 18, P 5 .004, respectively, and MFA 3.19 AE 2.40 vs 6.81 AE 1.60, P 5 .0001, respectively) (level IV).…”