Surgical treatment of synkinesis between smiling and eyelid closure

摘要: Abstract Synkinetic movements are common among patients with incomplete recovery from facial palsy, reported rates ranging 9.1% to almost 100%. The authors propose the separation of neural stimulus orbicularis oculi that zygomatic muscular complex treat eyelid closure/smiling synkinesis. This technique, associated an anastomosis between masseteric nerve and a central branch nerve, as well use cross-facial graft, resolves most spasms midface musculature, leading more relaxed tone when mimic muscle is at rest enhancing excursion during voluntary spontaneous smiling. Between 2011 2016, 18 affected by segmental paresis middle face underwent surgical treatment Maxillofacial Surgery Department San Paolo Hospital (Milan, Italy). Of these patients, 72.22% cases hypertone obtained partial complete relaxation. Synkinesis was completely resolved in 83.33% cases, significant improvement movement achieved all patients. Neurorrhaphy appears produce favorable results. These initial data should be confirmed further studies.