Individualized management of facial synkinesis based on facial function

Abstract

Objectives: The researchers analyzed facial patterns in subjects with facial synkinesis after facial paralysis and evaluated the involved muscles to aid in the development of effective treatments for facial synkinesis.

Methods: A total of 142 subjects were included in the study, the primary measure for synkinesis was determined by video analysis involving the strongest combination of two muscle groups that contributed to facial expression. The secondary measure of synkinesis was the analysis of its severity using the SB grading system, while observing the number of facial synkinetic movements.

Results: The most common type of facial synkinesis was oral–ocular synkinesis (n = 137). Other synkinesis such as ocular–oral, ocular–nasal, ocular–chin, ocular–stapedial, chin–ocular and chin–oral synkinesis continued to coexist together with oral–ocular synkinesis. The results of BTX-A treatment are assessed based on the number of facial synkinetic movements observed and the evaluation of initial facial function.

Conclusion: The effectiveness of botulinum toxin A (BTX-A) treatment should be considered on an individual basis, according to the initial state of facial function. A patient with mild facial synkinesis restricted to the oral–ocular area and with a high score on the Sunnybrook (SB) facial nerve grading system would be the best candidate for BTX-A treatment.

Chinese abstract

目的: 研究人员分析面部麻痹后面部肌肉联带运动的患者的面部模式, 并检测所涉及的肌肉, 以帮助开发有效的面部肌肉联带运动的治疗方案。

方法: 本研究包括142例受试者, 通过视频分析确定了肌肉联带运动的初步测量, 涉及两个主管面部表情的肌肉群的最强组合。肌肉联带运动的二次测量是使用SB分级系统分析其严重程度, 同时观察面部联带运动的运动次数。

结果: 最常见的面部肌肉联带运动类型是口腔同侧异位症（n = 137）。其它如眼 - 口、眼 - 鼻、眼 - 下颌、眼 - 吻、下颌 - 眼和下颌 - 口联带运动继续与口 - 眼联带运动同时存在。 对BTX-A治疗结果的检测是根据观察到的面部运动次数和初始面部功能的评估来进行的。

结论: , 肉毒毒素A（BTX-A）治疗的有效性应根据每个患者的脸部功能的初始状态来分别考虑。轻度面部联带的患者仅限于口腔眼部区域, 其Sunnybrook（SB）面部神经分级系统得分较高, 将是BTX-A治疗的最佳对象。

Keywords:

• Facial nerve
• facial paralysis
• facial synkinesis
• botulinum toxin A

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.