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Updated: Oct 17, 2026

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Comparing Casual Observer Perception of Facial Paralysis Subtypes
Nicholas R Randall1, Forrest W Fearington2, Lazaro R Peraza1
1Department of Otolaryngology - Head & Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Background:
There is a spectrum of clinical presentations after facial nerve injury, from complete facial paralysis (CFP) to facial synkinesis (FS).
Objective:
To measure and compare how laypersons perceive faces with CFP versus FS.
Methods:
Lay observers were presented with standardized videos of 24 individuals' faces: 8 with CFP, 8 with FS, and 8 nonparalyzed Controls performing common facial expressions. Observers were given a questionnaire and asked to rate the faces on varying subjective measurements of facial perception.
Results:
Five hundred and fifty-seven observers completed the survey. Observers viewed Control faces most favorably with higher perceived attractiveness and quality of life than CFP (p < 0.01; p < 0.01) and FS (p = 0.02; p < 0.01) faces. FS faces were rated more favorably than CFP faces (p < 0.01).
Conclusions:
There are measurable differences in how casual observers perceive faces with different subtypes of facial paralysis. Compared to nonparalyzed faces, both FS and CFP were viewed more negatively; however, CFP was perceived more negatively compared to FS.
Level Of Evidence:
N/A.
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