In this episode, host Dr. Ashley Agan discusses management of synkinesis with Dr. Shiayin (Shi) Yang, facial plastic surgeon at Vanderbilt University Medical Center.

The surgeons begin by defining synkinesis, a condition in which voluntary facial muscle movement triggers involuntary contraction of other facial muscles. Though the pathophysiology of synkinesis remains incompletely understood, damage to and aberrant “rewiring” of the facial nerve is thought to trigger these symptoms. Causes of synkinesis include Bell’s Palsy, facial tumors, and intra-operative injury. Dr. Yang explains the importance of appropriate patient counseling, especially given the misperception that synkinesis is a “disease of vanity.” The discussion then transitions to treatment options, including physical therapy, Botox injections, and surgical intervention (including myectomy and selective neurectomy). The podcast finishes with Dr. Yang’s insights into the mental health impact of synkinesis.

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SHOW NOTES

00:00 – Introduction

02:26 – Understanding Synkinesis

05:08 – Common Patient Presentations

06:11 – Importance of Early Treatment and Patient Education

07:48 – Referral and Timeliness of Treatment

09:35 – Pathophysiology of Nerve Rewiring

12:11 – Workup and Diagnosis

17:57 – Treatment Options: Botox Therapy

25:51 – Treatment Options: Surgical Interventions

30:31 – Long-term Management and Expectations

33:27 – Eye Protection in Facial Paralysis

37:16 – Mental Health Impact of Synkinesis

38:27 – Conclusion and Contact Information

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RESOURCES

Dr. Yang’s Vanderbilt University Medical Center profile:

https://search.vanderbilthealth.com/doctors/yang-shiayin