The Surgical Treatment of Facial Hyperkinesia

Botulinum toxin A injection in the treatment of hemifacial spasm

“…The overall successful rate of relief of spasm was 88%. This high percentage of improvement was better than those achieved with oral medication (17)(18)(19)(20), and was comparable to those by surgical decompression of posterior fossa (21)(22)(23)(24). The effect started 2 to 3 days after each injection and reached its maximum by 6 to 9 days later.…”

Cross-Facial Nerve Grafting for Facial Reanimation: Effect on Normal Hemiface Motion

“…3 Fisch stated that there was no evidence of facial weakness with division of peripheral (preparotid) branches of the facial nerve for the treatment of facial hyperkinesia. 11 Experience with tumor extirpation and trauma to the cheek region suggests that even when distal facial nerve branches are believed to be divided and are not repaired, there is often no clinically detectable deficit in facial motion after the passage of time. The explanation is that the facial nerve has a plethora of cross innervation to the various muscles of the zygomatic-buccal region.…”

Surgical Treatment for Postparalytic Facial Synkinesis: A 35-Year Experience

“…The mechanism of postparalytic facial synkinesis is extensively studied, but not well understood. [1][2][3][4] Recommended surgical treatments for postparalytic facial synkinesis in the literature include trunk neurectomy, 14 selective neurectomy, 15,16 highly selective neurectomy, 17 modified midface selective neurectomy, 18 selective myotomy or myectomy, 19,20 and extensive neurectomy and myectomy in the cheek and neck regions followed by functioning free muscle transplantation. 21 Each method has its advantages and disadvantages.…”