Selective Orbicularis Neuromyectomy: A Reliable Treatment for Periocular Synkinesis

Area of Science:

• Ophthalmology
• Neurology
• Plastic Surgery

Background:

• Postparetic periocular synkinesis significantly impacts quality of life.
• Selective orbicularis neuromyectomy emerged as a potential treatment in 2015.

Purpose of the Study:

• To statistically evaluate the long-term outcomes and stability of selective orbicularis neuromyectomy for postparetic periocular synkinesis.

Main Methods:

• Twenty-five patients with postparetic periocular synkinesis underwent selective orbicularis neuromyectomy.
• Patients were assessed using the Sunnybrook scale and palpebral fissure width measurements.
• A minimum of one-year follow-up was required, with no concurrent chemodenervation or physical therapy.

Main Results:

• Twenty patients met the inclusion criteria with a median follow-up of 32 months (range 13-96 months).
• A significant reduction in synkinesis scores (mean decrease of 4.6 points) was observed.
• Palpebral fissure width at rest and during puckering showed significant postoperative improvement (p < 0.01).
• One patient experienced late-onset lower lid drooping, successfully managed with secondary correction.

Conclusions:

• Selective orbicularis neuromyectomy is a simple and sustainable treatment for periocular synkinesis.
• The procedure demonstrates lasting efficacy for managing synkinesis symptoms.
• Further long-term studies in elderly populations and objective analyses are recommended.