Commentary to 'Botulinum toxin injection of both sides of the face to treat post-paralytic facial synkinesis'

摘要

Related to the terminology There are many similar terms being used to describe the movement disorder in the literatures, such as facial synki-nesis, hemifacial synkinesis, aberrant facial nerve regeneration syndrome, secondary hemifacial spasm, post-facial palsy synkinesis, post-paralytic facial synkinesis, post-facial paralysis synkinesis, or postparetic facial synkinesis. However, paralysis, a synonym for palsy, usually means a complete form. Paresis is an incomplete form. Synkinesis, a synonym for co-contraction, only occurs in incomplete paralysis. Therefore, postparetic facial synkinesis (PPFS) is more precious than postparalytic facial synkinesis. Related to the treatment Postparetic facial synkinesis (PPFS) is a healing process of facial nerve injury with many various presentation. It likes scar formation. Scar is a healing process of wounds with similarly many various presentation. Not all scars are treated conservatively. Some bad and ugly scars should be treated by more aggressive procedure, such as wide excision and reconstruction with local or distant flap. Treatment of PPFS is the same. Some severe types require more aggressive procedure, such as radical excision of the syn-kinetic muscles and nerves, and reconstructed by functioning free muscle for facial reanimation, like treatment for chronic facial paralysis. I have presented this in the 2013 ASRM at the Waldorf Astoria Naples hotel this January.