A Zonal Denervation Approach to Surgical Management of Facial Synkinesis
Roy Xiao, Elizabeth R. McGonagle, Catherine F. Roy, Tessa A. HadlockBackground:
While selective neurectomy has emerged as a surgical adjunct for patients with facial synkinesis to eliminate aberrantly regenerated axons, postoperative outcomes have been mixed.
Objective:
To understand how a zonal denervation approach to selective neurectomy targeting a broader elimination of unwanted neural elements can affect periocular and perioral movements among patients with facial synkinesis.
Methods:
We retrospectively assessed patients who underwent zonal denervation from July 2023 through August 2024. Pre- and postoperative photographs were analyzed in a blinded fashion using Emotrics and eFACE; postoperative changes were compared within patients using Wilcoxon matched-pairs signed rank tests.
Results:
We included 20 zonal denervation patients who were primarily female (90%) with median age of 51 years (interquartile range 42–63) and most often developed initial facial paralysis due to viral etiology (45%). These patients experienced significant improvement in median oral commissure excursion from 2.50 mm to 5.88 mm (
Conclusions:
Zonal denervation is an effective technique to improve periocular and perioral synkinesis.