Pathogenesis, diagnosis and therapy of facial synkinesis: A systematic review and clinical practice recommendations by the international head and neck scientific group.
Bell's palsy
EMG feedback training
aberrant regeneration
botulinum toxin
electromyography
electrostimulation
facial synkinesis
surgery
Journal
Frontiers in neurology
ISSN: 1664-2295
Titre abrégé: Front Neurol
Pays: Switzerland
ID NLM: 101546899
Informations de publication
Date de publication:
2022
2022
Historique:
received:
15
08
2022
accepted:
13
10
2022
entrez:
28
11
2022
pubmed:
29
11
2022
medline:
29
11
2022
Statut:
epublish
Résumé
Post-paralytic facial synkinesis after facial nerve injury produces functional disabilities and mimetic deficits, but also cosmetic and non-motor psychosocial impairments for the patients. These patients typically have a high and continuous high motivation for rehabilitation. The aim is to inform the affected patients and their therapeutic professionals (otorhinolaryngologist - head and neck surgeons; oral-maxillofacial surgeons, plastic and reconstructive surgeons, neurosurgeons, neurologists, and mime therapists be it speech and language therapy- or physiotherapy-based) and to provide practical recommendations for diagnostics and a stepwise systematic treatment approach of facial synkinesis. In the first phase, a systematic literature search on the topic in PubMed and ScienceDirect starting in 2008 resulted in 132 articles. These were the basis for the review and a comprehensive series of consensus statements on the most important diagnostic tests and treatment options. In the second phase, one consensus article circulated among the membership of the International Head and Neck Scientific Group until a final agreement was reached for all recommendations. Diagnostics should include a standardized assessment of the degree of synkinesis using validated clinician-graded instruments and synkinesis-specific patient-reported outcome measures. Treatments for facial synkinesis include facial training mainly based on facial biofeedback retraining, chemodenervation with botulinum toxin, selective neurectomy, myectomy, and any combination treatment of these options. A basic understanding of the pathomechanisms of synkinesis is essential to understand the treatment strategies. A standardized assessment of the synkinetic symptoms and the individual synkinesis pattern is needed. The first-line treatment is facial training, followed by botulinum toxin. Surgery is reserved for individual cases with unsatisfactory first-line treatment.
Identifiants
pubmed: 36438936
doi: 10.3389/fneur.2022.1019554
pmc: PMC9682287
doi:
Types de publication
Systematic Review
Langues
eng
Pagination
1019554Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Informations de copyright
Copyright © 2022 Guntinas-Lichius, Prengel, Cohen, Mäkitie, Vander Poorten, Ronen, Shaha and Ferlito.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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