Modified Selective Neurectomy: A New Paradigm in the Management of Facial Palsy with Synkinesis

Babak Azizzadeh; Nikolaus Hjelm

doi:10.1016/j.fsc.2021.03.005

Modified Selective Neurectomy: A New Paradigm in the Management of Facial Palsy with Synkinesis

Facial Plast Surg Clin North Am. 2021 Aug;29(3):453-457. doi: 10.1016/j.fsc.2021.03.005.

Authors

Babak Azizzadeh¹, Nikolaus Hjelm²

Affiliations

¹ The Facial Paralysis Institute, 9401 Wilshire Boulevard, Suite 650, Beverly Hills, CA 90212, USA.
² The Facial Paralysis Institute, 9401 Wilshire Boulevard, Suite 650, Beverly Hills, CA 90212, USA. Electronic address: [email protected].

PMID: 34217449
DOI: 10.1016/j.fsc.2021.03.005

Abstract

All patients with postparalytic facial paralysis are at risk of developing synkinesis due to aberrant nerve regeneration. Synkinesis can result in smile dysfunction, tension, and eyelid aperture narrowing due to overactive and uncoordinated muscle activity. When the synkinesis causes an asymmetric smile, there are several treatment modalities including neurotoxin, neuromuscular retraining, and surgery. Modified selective neurectomy of the facial nerve is a treatment option that potentially can improve the smile mechanism by reducing the activity of counterproductive facial muscles while preserving the natural neural pathway.

Keywords: Facial paralysis; Modified selective neurectomy; Smile; Synkinesis.

Publication types

Review

MeSH terms

Denervation
Facial Nerve / surgery
Facial Paralysis* / surgery
Humans
Smiling
Synkinesis* / etiology
Synkinesis* / surgery