Eye Soft Surgery for Facial Sinkynesis

University of Catania25 enrolled

Overview

Facial synkinesis (FS) is a distressing sequela of facial palsy (FP) characterized by involuntary, simultaneous movements of facial muscles occurring during voluntary facial expressions. Treatment of synkinesis is challenging, and preventive methods are needed. This study evaluates the efficacy of physical facial nerve rehabilitation (PFNR) therapy alone versus PNFR with eyelid surgery to correct lagophthalmos and prevent the onset of synkinesis. 25 outpatients are randomized to receive either PFNR alone (neuromuscular retraining and Kabat proprioceptive neuromuscular facilitation) or PNFR and early (90 days after FP onset) eyelid surgery (involving a conservative oculoplastic correction for lagophthalmos with epiphora or ectropion). Comprehensive otolaryngological assessments and Magnetic Resonance Imaging (MRI) will be conducted. Synkinesis progression was measured using Another Disease Scale (ADS) at baseline, 3 months 6 months, 12 months, and 24-months post-treatment. The data were analyzed with ANOVA, t-test, Chi-Square analyses.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Enrollment

Conditions

Facial Paralysis Sinkynesis

Eye soft surgeryPROCEDURE

Early lower eyelid surgery will be performed in accordance with the protocol previously described by Di Stadio, with medial or lateral eyelid lifting surgery as indicated. The indication for eye surgery are in case of ectropion (exposure of the conjunctiva due to a reduction in tension of the anterior compartment of the eye muscle) and lagophthalmos (incomplete /abnormal closure of the eye with eyelid in closed position) a lateral lower eyelid lifting surgery is performed. otherwise, in presence of epiphora (the eversion of the lachrymal point) and lagophthalmos medial lower eyelid lifting surgery is done.

Physical RehabilitationOTHER

Kabat therapy and neuromuscular reeducation (NMR) at home Kabat therapy involved thrice-weekly 35-minute sessions.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * people over 18 years old * willingness to participate * acute/new onset of FP (less than 15 days) Exclusion Criteria: * neuro-inflammatory diseases (e.g., Multiple Sclerosis) * FP from systemic disorders (e.g., Guillain-Barré syndrome, Lyme disease, encephalitis) * FP from middle ear infections or untreated cholesteatoma * severe cognitive or psychological disorders * non-consent to participate in the study

Outcomes

Primary Outcomes

Sinkinesis

Presence or absence

Time frame: 3, 6, 12, 24 months

Secondary Outcomes

Recovery of Facial motility

ADS will be used to evaluate the recovery of facial motility

Time frame: 3, 6, 12, 24 months

Time to recover facial motility

Evaluation of months needed to recover

Time frame: 3, 6, 12, 24 months

Eye Soft Surgery for Facial Sinkynesis

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes