{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:33:33Z","timestamp":1790285613890,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T00:00:00Z","timestamp":1701648000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Facial selective neurectomy (SN) improves facial function by denervation of muscles antagonistic to the smile in nonflaccid facial paralysis (NFFP) patients. This study aims to assess whether and which objective facial function metrics affect favorable SN outcome in NFFP patients, as perceived by facial nerve (FN) practitioners.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>NFFP patients who underwent SN at the facial nerve center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Standardized preoperative and postoperative facial photographs of patients undergoing SN were analyzed using clinician\u2010graded measures (eFACE) and automated facial measurement (Emotrics). Favorable outcome was ranked subjectively by 3 independent FN practitioners. Correlations between objective metrics and favorable subjective outcome were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010eight SN cases were included. Oral commissure excursion with smile, interlabial distance, and lower lip movement were all considered statistically significantly important for favorable outcome perception. Each +1\u2009mm of smile excursion increases the odds of a favorable outcome by 75.4% (odds ratio [OR]: 1.754). Each +1\u2009mm of interlabial distance asymmetry decreases the odds of a favorable outcome by 24.7% (OR: 0.753). Each +1\u2010point change in lower lip movement eFACE score increases the odds of a favorable outcome by 2.7% (OR: 1.027).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Several smile metrics contribute to favorable SN outcome perception among FN practitioners. Smile excursion, interlabial distance, and lower lip movement were significant predictors of success. These observations may be extrapolated to other facial reanimation interventions and serve surgeons and patients during counseling and expectation management, and during surgery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.598","type":"journal-article","created":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T02:58:30Z","timestamp":1701745110000},"page":"1045-1050","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Favorable Outcome Perception in Facial Selective Neurectomy"],"prefix":"10.1002","volume":"170","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0963-7089","authenticated-orcid":false,"given":"Tal","family":"Kaufman Goldberg","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Flynn","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren O.","family":"Trzcinski","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa A.","family":"Hadlock","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27481"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2016.1462"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fsc.2015.04.005"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1075840"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-193705000-00002"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2018.07.012"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000005590"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/00207450590914464"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/fpsam.2022.0422"},{"key":"e_1_2_8_11_1","first-page":"190","article-title":"Selective neurectomy for treatment of post facial paralysis synkinesis: a systematic review","volume":"39","author":"Shikara M","year":"2022","journal-title":"Facial Plast Surg"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000001447"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002954"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2018.0030"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/archfaci.2010.101"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2009.08.011"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.598","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T13:32:50Z","timestamp":1760967170000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.598"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,4]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1002\/ohn.598"],"URL":"https:\/\/doi.org\/10.1002\/ohn.598","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,4]]},"assertion":[{"value":"2023-07-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}