{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T23:25:07Z","timestamp":1785885907739,"version":"3.56.0"},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,4,18]],"date-time":"2018-04-18T00:00:00Z","timestamp":1524009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective of this study was to investigate the long\u2010term effect and treatment stability of selective neurectomy for refractory periocular synkinesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective review of all patients treated with highly selective neurectomy for refractory periocular synkinesis between August 2009 and August 2015. Primary outcome was time to recommencing treatment for periocular synkinesis. Palpebral fissure width was measured preoperatively, postoperatively, and at long\u2010term (\u2009&gt;\u20092.5 years) follow\u2010up. Mean units of botulinum toxin used pre\u2010 and postoperatively were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 12 patients, 10 could be included. Only one was free of treatment for periocular synkinesis at a follow\u2010up of 3.5 years. The other nine patients recommenced treatment with botulinum toxin after a median time of 1.2 (interquartile range 0.6\u20132.6) years. Palpebral fissure width while smiling was significantly different between the pre\u2010 and postoperative (<jats:italic>P<\/jats:italic>\u2009=\u20090.008) and preoperative and long\u2010term (<jats:italic>P<\/jats:italic>\u2009=\u20090.008) measurements. Postoperatively, previously refractory patients demonstrated good response to botulinum toxin treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrates that most patients require renewed pharmacological treatment of periocular synkinesis after neurectomy. Although the effect of neurectomy in the treatment of refractory synkinesis does not appear to be sustained, patients usually experience a symptom\u2010free interval and demonstrate larger palpebral fissure width at long\u2010term follow\u2010up compared to preoperative measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 128:2291\u20132295, 2018<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27225","type":"journal-article","created":{"date-parts":[[2018,4,18]],"date-time":"2018-04-18T14:31:41Z","timestamp":1524061901000},"page":"2291-2295","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Long\u2010term outcome of selective neurectomy for refractory periocular synkinesis"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2233-2068","authenticated-orcid":false,"given":"Martinus M.","family":"van Veen","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\/Head and Neck Surgery Massachusetts Eye and Ear Infirmary and Harvard Medical School Boston Massachusetts U.S.A"},{"name":"Department of Plastic Surgery University Medical Center Groningen and University of Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph R.","family":"Dusseldorp","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\/Head and Neck Surgery Massachusetts Eye and Ear Infirmary and Harvard Medical School Boston Massachusetts U.S.A"},{"name":"Department of Plastic and Reconstructive Surgery Royal Australasian College of Surgeons and University of Sydney Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa A.","family":"Hadlock","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\/Head and Neck Surgery Massachusetts Eye and Ear Infirmary and Harvard Medical 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