{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:12:11Z","timestamp":1772989931392,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:00:00Z","timestamp":1740614400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Synkinesis is a distressing sequela of facial palsy. The main treatment for this condition has been Botulinum toxin injections. However, more recently, selective neurolysis\/neurectomies have shown promise, with some variations in practice evolving over time. A clinical review of practice was performed on sixty\u2010eight patients (<jats:italic>n<\/jats:italic>\u2009=\u200968) with Bell's palsy over five years (2018\u20132023) who underwent synkinesis surgery, following facial palsy. Comparisons were made between platysmal myoneurectomy only (Group I), platysmal myoneurectomy and zygomaticus major\/levator labii superior direct neurotization (Group II), platysmal myoneurectomy and depressor anguli oris (DAO) selective neurectomy (Group III) and platysmal myoneurectomy\u2009+\u2009DAO and buccinator selective neurectomies (Group IV). The following outcome measures were used: Sunnybrook Facial Grading Scale (FGS), Facial Clinimetric Evaluation (FaCE), Facial Disability Index (FDI), and Synkinesis Assessment Questionnaire (SAQ). Statistical analyses were performed using the student's <jats:italic>t<\/jats:italic>\u2010test and ANOVA. There was an overall improvement for patients pre\u2010 and post\u2010operatively (42.34\u2009\u00b1\u200916.37 vs. 65.12\u2009\u00b1\u200914.34; Student's <jats:italic>t<\/jats:italic>\u2010test, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). All FGS scores showed statistically significant (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) improvement. FDI\u2010physical, SAQ, and FaCE showed statistically significant improvements, apart from the FDI\u2010social (<jats:italic>p<\/jats:italic>\u2009=\u20090.08). Qualitatively, all procedures showed significant improvement compared with their pre\u2010op state, with Group IV showing the best results among platysmal myoneurectomy variants in terms of repose, volitional movements, and synkinesis reduction compared with its contemporaries.<\/jats:p>","DOI":"10.1002\/micr.70040","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T05:24:24Z","timestamp":1741757064000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Comparative Study of Platysmal Myoneurectomy With Variations of Selective Neurectomies in Post\u2010Facial Palsy Synkinesis"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6932-2771","authenticated-orcid":false,"given":"Maria","family":"Paranhos Barbot","sequence":"first","affiliation":[{"name":"Brighton &amp; Sussex Medical School  Brighton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catriona","family":"Neville","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Queen Victoria Hospital  East Grinstead UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamsin","family":"Gwynn","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Queen Victoria Hospital  East Grinstead UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Queen Victoria Hospital  East Grinstead UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Crystal","family":"Selley\u2010West","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Queen Victoria Hospital  East Grinstead UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raman","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Queen Victoria Hospital  East Grinstead UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Nduka","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Queen Victoria Hospital  East Grinstead UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruben Yap","family":"Kannan","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Queen Victoria Hospital  East Grinstead UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,2,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2018.07.012"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/prs.0000000000005590"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.186.3.239"},{"key":"e_1_2_9_5_1","first-page":"1","article-title":"IB2d: A Python and MATLAB Implementation of the Immersed Boundary Method","volume":"12","author":"Battista N.","year":"2016","journal-title":"Bioinspiration & Biomimetics"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2005.09.003"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24732"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cxom.2022.09.006"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200103000-00005"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/gox.0000000000005811"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.5115\/acb.2019.52.1.1"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00788.2018"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archfaci.2010.39"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/mlg.0b013e3180412460"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20868"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1756352"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/photonics8080341"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2021.05.045"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2012.189"},{"key":"e_1_2_9_20_1","first-page":"1","article-title":"Facial Synkinesis: A Distressing Sequela of Facial Palsy","volume":"0","author":"Shokri T.","year":"2021","journal-title":"Ear, Nose, & Throat Journal"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-09960-8"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2010.04.045"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/76.12.1288"},{"key":"e_1_2_9_24_1","first-page":"2291","article-title":"Long\u2010Term Outcome of Selective Neurectomy for Refractory Periocular Synkinesis","volume":"128","author":"Veen M. 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