Selective orbicularis neuromyectomy for postparetic periocular synkinesis

Area of Science:

• Ophthalmology
• Plastic Surgery
• Neurology

Background:

• Facial synkinesis, characterized by involuntary facial movements, often follows incomplete recovery from facial paralysis.
• Periocular synkinesis, affecting the eye area, can cause significant distress and functional impairment.

Purpose of the Study:

• To evaluate the efficacy of selective orbicularis neuromyectomy as a surgical treatment for periocular synkinesis.
• To assess the impact of this procedure on ocular hypertonicity and synkinetic eye closure.

Main Methods:

• A cohort of 11 patients with postparetic facial synkinesis underwent selective orbicularis neuromyectomy.
• Patients presented with ocular hypertonicity and synkinetic eye closure during voluntary oral movements.
• Facial function was assessed using the Sunnybrook scale pre- and post-surgery.

Main Results:

• All 11 patients experienced reduced ocular hypertonicity and less pronounced synkinetic eye movements post-procedure.
• The mean synkinesis score decreased by 48% (4.5 points) after surgery.
• One patient developed temporary lower lid ectropion, which was successfully repaired; no other complications were reported.

Conclusions:

• Selective orbicularis neuromyectomy is a simple and effective surgical intervention for periocular synkinesis.
• This procedure offers a viable alternative treatment for patients suffering from synkinesis after facial paralysis.