Pre-Operative Factors May Predict Outcome in Selective Neurectomy for Synkinesis

Abstract

Background:

While there has been great interest in offering selective neurectomy (SN) to patients with nonflaccid facial palsy (NFFP), postoperative outcomes are inconsistent.

Objective:

To assess overall SN outcome in NFFP patients and to examine correlation between preoperative factors and SN outcome.

Methods:

SN cases were retrospectively identified between 2019 and 2021. Patient factors and facial function were assessed using chart review, the Facial Clinimetric Evaluation (FaCE), the electronic clinician-graded facial function tool (eFACE), and an automated computer-aided facial assessment tool (Emotrics). Correlations between preoperative factors and patients outcome were established.

Results:

Fifty-eight SN cases were performed; 88% were females, and median age was 53 years (range 11–81). Outcome assessment was 8 months on average (1–24 months). Postoperatively, multiple eFACE and Emotrics parameters improved significantly, including ocular, perioral, and synkinesis metrics. In preoperative factors assessment, age >50, facial palsy (FP) duration >2 years, poor preoperative facial function, and nontrauma etiology all correlated with greater improvements compared with younger patients, those with shorter duration facial palsy, trauma etiology, and better preoperative facial function.

Conclusions:

SN can significantly improve facial function; we have identified several preoperative factors that correlated to outcome.