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Related Experiment Videos

Selective myectomy for postparetic facial synkinesis.

J O Guerrissi1

  • 1Division of Plastic Surgery, Hospital José Maria Ramos Mejia, Buenos Aires, Argentina.

Plastic and Reconstructive Surgery
|March 1, 1991
PubMed
Summary

Facial palsy can lead to synkinetic movements due to abnormal nerve regeneration. Surgical resection of affected perioral muscles offers good aesthetic results for severe cases.

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Area of Science:

  • Neurology
  • Ophthalmology
  • Plastic Surgery

Background:

  • Synkinetic movements are a common sequela of facial palsy, resulting from aberrant regeneration of facial nerve axons.
  • These involuntary movements occur due to misdirected regenerating nerve fibers, as suggested by the Lippschitz theory.
  • Facial nerve lesions in the trunk, proximal to major branching, are implicated in the development of synkinesis.

Purpose of the Study:

  • To evaluate the incidence of synkinetic movements following spontaneous recovery from facial palsy.
  • To assess the efficacy of a novel surgical approach for correcting severe synkinetic movements.
  • To investigate the long-term aesthetic and functional outcomes of the proposed surgical treatment.

Main Methods:

  • Retrospective evaluation of 71 patients with facial paralysis between 1975 and 1986.
  • Analysis of spontaneous recovery rates and the development of synkinetic movements.
  • Surgical intervention involving resection of involved perioral muscle groups in 6 patients with severe aesthetic disturbances.

Main Results:

  • Spontaneous recovery occurred in 28 patients, with 14 (50%) developing synkinetic movements.
  • The most common synkinesis involved the orbicularis oculi and elevators of the mouth corner.
  • Surgical treatment through perioral muscle resection yielded good aesthetic results in 6 patients with no functional sequelae.

Conclusions:

  • Synkinetic movements are a frequent complication of facial palsy recovery.
  • Surgical resection of perioral muscles is an effective treatment for severe synkinesis, improving aesthetic outcomes.
  • The proposed surgical technique offers a viable solution for patients with significant aesthetic concerns due to synkinetic movements.

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