Modified Selective Neurectomy for the Treatment of Post-Facial Paralysis Synkinesis

Plastic and Reconstructive Surgery
Babak AzizzadehGrace Lee Peng

Abstract

To address functional and smile dysfunction associated with post-facial paralysis synkinesis, the senior author (B.A.) has offered "modified selective neurectomy" of the lower division of the facial nerve as a long-term solution. This article examines technical considerations and outcomes of this procedure. A retrospective review was conducted of patients who underwent modified selective neurectomy of buccal and cervical branches of the facial nerve performed by a single surgeon over a 4½-year period. House-Brackmann facial grading scores, electronic clinician-graded facial function scale, and onabotulinumtoxinA (botulinum toxin type A) dosages were examined before and after the procedure. Sixty-three patients underwent modified selective neurectomy between June 20, 2013, and August 12, 2017. There were no serious complications. The revision rate was 17 percent. Temporary oral incompetence was reported in seven patients (11 percent) postoperatively. A statistically significant improvement was achieved in electronic clinician-graded facial function scale analysis of nasolabial fold depth at rest, oral commissure movement with smile, nasolabial fold orientation with smile, nasolabial depth with smile, depressor labii inferioris l...Continue Reading

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Citations

Aug 30, 2019·JAMA Facial Plastic Surgery·Aurora G VincentMarc H Hohman
Mar 5, 2020·Facial Plastic Surgery & Aesthetic Medicine·Matthew Q Miller, Tessa A Hadlock
Mar 25, 2020·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Jie MaJian-Guang Xu
Feb 14, 2020·Facial Plastic Surgery & Aesthetic Medicine·Nikolaus Hjelm, Babak Azizzadeh
Sep 25, 2020·JAMA Otolaryngology-- Head & Neck Surgery·Nneoma S WamkpahJohn J Chi
Oct 29, 2020·Journal of Neuro-oncology·Laura H ChristopherBabak Azizzadeh
Dec 11, 2020·Facial Plastic Surgery & Aesthetic Medicine·Brittany Leader, Babak Azizzadeh
Oct 31, 2020·Facial Plastic Surgery & Aesthetic Medicine·Matthew Q Miller, Tessa A Hadlock
Jan 1, 2021·Seminars in Plastic Surgery·Tom ShokriYadranko Ducic
Feb 20, 2021·Facial Plastic Surgery & Aesthetic Medicine·Julie P ShtraksBabak Azizzadeh
Apr 29, 2021·Neural Regeneration Research·Jia-Jia WuJian-Guang Xu
May 7, 2021·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Maya ZaidmanRonald M Zuker
Jun 30, 2021·Current Opinion in Otolaryngology & Head and Neck Surgery·Anthony SanchezJennifer C Fuller
Jul 9, 2021·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Elena PescariniRuben Y Kannan
Jul 5, 2021·Facial Plastic Surgery Clinics of North America·Babak Azizzadeh, Nikolaus Hjelm
Jan 26, 2022·Plastic and Reconstructive Surgery·Adeeb DerakhshanTessa A Hadlock
Feb 2, 2022·Facial Plastic Surgery & Aesthetic Medicine·Matthew Q Miller, J Madison Clark

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