Botulinum toxin A treatment in facial palsy synkinesis: a systematic review and meta-analysis

Jongh, Frank W. de; Schaeffers, Anouk W M A; Kooreman, Zoë E; Ingels, K.J.A.O.; Heerbeek, Niels van; Beurskens, Carien H. G.; Monstrey, Stan; Pouwels, Sjaak

doi:10.1007/s00405-022-07796-8

Cited by 13 publications

(13 citation statements)

References 62 publications

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“…Due to inconsistencies in reporting, follow-up and outcome measurements, no other analysis was possible. 36 Management Strategies -Facial therapy:…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…They include, but are not limited to, hematomas, headache, stiff face, difficulty speaking, ptosis of both lip and eyes, dry eyes, diplopia, and epiphora. 25,36 Unfortunately, studies seldomly report and elaborate on these adverse events and those that do present heterogeneous data that are incomplete, making it impossible to reliably estimate their incidence in PPFS patients treated with BTX-A in comparison to the general population. 36 A recent meta-analysis tried to objectify the benefit of BTX-A in patients with synkinesis.…”

Section: Chemodenervationmentioning

confidence: 99%

“…25,36 Unfortunately, studies seldomly report and elaborate on these adverse events and those that do present heterogeneous data that are incomplete, making it impossible to reliably estimate their incidence in PPFS patients treated with BTX-A in comparison to the general population. 36 A recent meta-analysis tried to objectify the benefit of BTX-A in patients with synkinesis. Of the 4,299 articles screened, only three studies (covering 106 patients) met the criteria for inclusion in the quantitative analysis.…”

Section: Chemodenervationmentioning

confidence: 99%

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Approaches to the Management of Synkinesis: A Scoping Review

Zubler,

Punreddy,

Mayorga-Young

et al. 2024

Facial Plast Surg

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Post-paralysis facial synkinesis can develop in any facial palsy and is associated with significant functional and psychosocial consequences for affected patients. While the prevention of synkinesis especially after Bell’s Palsy has been well examined, much less evidence exists regarding the management of patients with already established synkinesis. Therefore, the purpose of this review is to summarize the available literature and to provide an overview of the current therapeutic options for facial palsy patients with established synkinesis. A systematic literature review was undertaken, following the PRISMA 2020 guidelines. MEDLINE via PubMed and Cochrane Library were searched using the following strategy: ((facial palsy) OR (facial paralysis) OR (facial paresis)) AND (synkinesis) AND ((management) OR (guidelines) OR (treatment)). The initial search yielded 201 articles of which 36 original papers and 2 meta-analyses met the criteria for inclusion. Overall, the included articles provided original outcome data on 1408 patients. Articles were divided into the following treatment categories: chemodenervation (12 studies, 536 patients), facial therapy (5 studies, 206 patients), surgical (10 studies, 389 patients) and combination therapy (9 studies, 278 patients). Results are analyzed and discussed accordingly. Significant heterogeneity in study population and design, lack of control groups, differences in postoperative follow-up as well as the use of a variety of subjective and objective assessment tools to quantify synkinesis prevent direct comparison between treatment modalities. To date there is no consensus on how post-paralysis facial synkinesis is best treated. The lack of comparative studies and standardized outcome reporting hinder our understanding of this complex condition. Until higher-quality scientific evidence is available, it remains a challenge best approached in an interdisciplinary team. An individualized multimodal therapeutic concept consisting of facial therapy, chemodenervation and surgery should be tailored to meet the specific needs of the patient.

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“…Due to inconsistencies in reporting, follow-up and outcome measurements, no other analysis was possible. 36 Management Strategies -Facial therapy:…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Chemodenervationmentioning

confidence: 99%

Section: Chemodenervationmentioning

confidence: 99%

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Approaches to the Management of Synkinesis: A Scoping Review

Zubler,

Punreddy,

Mayorga-Young

et al. 2024

Facial Plast Surg

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“…Botulinum toxin reduces or even eliminates the contractibility of the involuntarily co-contracted muscle or muscle group. Botulinum Toxin A (BTX-A) is frequently used as a safe and effective treatment [ 22 , 24 , 26 , 29 , 41 , 42 ]. Injecting the muscle with synkinesis at the right dose blocks this involuntary contraction while allowing the muscle to maintain its initial motor function.…”

Section: Toxin Botulinum In Patients With Sequelae Of Peripheral Faci...mentioning

confidence: 99%

“…The dose and injection points vary individually according to the severity of synkinesis or hyperkinesy, but also according to the muscle being treated [ 26 , 41 ].…”

Section: Toxin Botulinum In Patients With Sequelae Of Peripheral Faci...mentioning

confidence: 99%

Botulinum Toxin Injections to Manage Sequelae of Peripheral Facial Palsy

Carré,

Amar,

Tankéré

et al. 2024

Toxins

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Long-standing facial palsy sequelae cause functional, aesthetic, and psychological problems in patients. Botulinum toxin is an effective way to manage them, but no standardized recommendations exist. Through this non-systematic review, we aimed to guide any practitioner willing to master the ins and outs of this activity. We reviewed the existing literature and completed, with our experience as a reference center, different strategies of botulinum toxin injections used in facial palsy patients, including history, physiopathology, facial analysis, dosages, injection sites, and techniques, as well as time intervals between injections. The reader will find all the theorical information needed to best guide injections according to the patient’s complaint, which is the most important information to consider.

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A complex orthosurgical approach in Class III malocclusion correction involving traumatic dental injuries and maxilla fracture: A 9-year posttreatment update

Rédua

2023

AJO-DO Clinical Companion

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Botulinum toxin A treatment in facial palsy synkinesis: a systematic review and meta-analysis

Cited by 13 publications

References 62 publications

Approaches to the Management of Synkinesis: A Scoping Review

Approaches to the Management of Synkinesis: A Scoping Review

Botulinum Toxin Injections to Manage Sequelae of Peripheral Facial Palsy

A complex orthosurgical approach in Class III malocclusion correction involving traumatic dental injuries and maxilla fracture: A 9-year posttreatment update

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