Abstract | BACKGROUND: METHODS: A total of 353 patients (age, 4 to 84 years; 245 female patients) with longstanding facial paralysis underwent 2312 botulinum toxin type A injections during an 11-year follow-up. Doses used over the years, previous treatments (electrical stimulation, operations), and how they correlated to postparalysis and postreanimation synkinesis were analyzed. RESULTS: There was a significant association between cause and surgery. Most patients with facial paralysis caused by a congenital defect, trauma, or a tumor underwent reanimation. There were no sex- or synkinesis-related differences in the doses used, but the doses were higher in the reanimation group than in the no-surgery group. Synkinesis was found in 196 patients; 148 (41.9 percent) presented with postparalysis synkinesis (oro-ocular, oculo-oral) and 58 (16.4 percent) presented with postreanimation synkinesis. Ten patients presented with both types. CONCLUSIONS: This study determined the high prevalence (55.5 percent) of synkinesis in patients with longstanding facial paralysis. Postparalysis synkinesis was positively associated with infectious and idiopathic causes, electrical stimulation, facial nerve decompression, and no requirement for surgery. Postreanimation synkinesis was present in 28.2 percent of reanimated patients and was significantly associated with microsurgical flaps, transfacial nerve grafting, masseteric-facial anastomosis, and temporalis muscle transfers.
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Authors | Alessandra Grassi Salles, Eduardo Fernandes da Costa, Marcus Castro Ferreira, Adelina Fatima do Nascimento Remigio, Luciana Borsoi Moraes, Rolf Gemperli |
Journal | Plastic and reconstructive surgery
(Plast Reconstr Surg)
Vol. 136
Issue 6
Pg. 1289-1298
(Dec 2015)
ISSN: 1529-4242 [Electronic] United States |
PMID | 26595022
(Publication Type: Clinical Study, Journal Article)
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Chemical References |
- Neuromuscular Agents
- Botulinum Toxins, Type A
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Botulinum Toxins, Type A
(therapeutic use)
- Child
- Child, Preschool
- Facial Asymmetry
(drug therapy, etiology)
- Facial Paralysis
(complications)
- Female
- Humans
- Male
- Middle Aged
- Neuromuscular Agents
(therapeutic use)
- Prevalence
- Retrospective Studies
- Synkinesis
(drug therapy, epidemiology, etiology)
- Time Factors
- Young Adult
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