{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:59:23Z","timestamp":1785761963626,"version":"3.56.0"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,3,4]],"date-time":"2020-03-04T00:00:00Z","timestamp":1583280000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Sydney Facial Nerve Clinic (SFNC) is a multidisciplinary clinic established in 2015, consisting of surgeons (otolaryngologists, head and neck and plastics\/reconstructive), physiotherapists and speech pathologists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed patients who attended the SFNC in the first 3\u2009years and who had their symptoms recorded using the Facial Disability Index, and clinical staging recorded utilising the House\u2013Brackmann (HB) score, Sydney Facial Nerve Score and Sunnybrook Facial Grading System (SFGS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between May 2015 and June 2018, 145 patients attended the clinic. Mean age was 44.6\u2009\u00b1\u200917.3\u2009years with 94 (64.8%) females. Most referrals came from general practitioners (<jats:italic>n<\/jats:italic> =\u200975, 54.5%). The most common aetiology was iatrogenic injury (<jats:italic>n<\/jats:italic> =\u200955, 37.9%), followed by Bell's palsy (<jats:italic>n<\/jats:italic> =\u200948, 33.1%), congenital (<jats:italic>n<\/jats:italic> =\u200911, 7.6%), herpes zoster oticus (<jats:italic>n<\/jats:italic> =\u20099, 6.2%), trauma (<jats:italic>n<\/jats:italic> =\u20099, 6.2%) and other (<jats:italic>n<\/jats:italic> =\u200913, 9.0%). The median HB was 4, the mean Sydney score 7.3\/15 and the mean SFGS was 45\/100. Patients with iatrogenic causes had the worse facial nerve scoring in HB, Sydney and SFGS. Patients with congenital aetiology reported the least symptoms on Facial Disability Index (<jats:italic>P<\/jats:italic> &lt;\u20090.001). Most patients were recommended non\u2010surgical management (<jats:italic>n<\/jats:italic> =\u200992, 64.3%); 51 (35.7%) were referred for botulinum toxin\u2009+\u2009facial physiotherapy, 25 (17.2%) for physiotherapy alone, seven (4.9%) for botulinum toxin alone and nine (6.3%) for conservative management. Fifty\u2010one patients (35.7%) were recommended surgery, generating 75 procedures; 24 oculoprotective, 22 static, 12 gracilis transfers, 10 temporalis myoplasties and seven nerve transfers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Iatrogenic injuries are the most common presentation for this clinic and have a more severe clinical presentation. Most patients presenting to the SFNC were managed non\u2010surgically.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.15782","type":"journal-article","created":{"date-parts":[[2020,3,4]],"date-time":"2020-03-04T10:26:24Z","timestamp":1583317584000},"page":"856-860","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Sydney Facial Nerve Clinic: experience of a multidisciplinary team"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8489-4483","authenticated-orcid":false,"given":"Raymond","family":"Hayler","sequence":"first","affiliation":[{"name":"Sydney Medical School The University of Sydney  Sydney New South Wales Australia"},{"name":"Sydney Facial Nerve Clinic Chris O'Brien Lifehouse  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Clark","sequence":"additional","affiliation":[{"name":"Sydney Medical School The University of Sydney  Sydney New South Wales Australia"},{"name":"Sydney Facial Nerve Clinic Chris O'Brien Lifehouse  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen","family":"Croxson","sequence":"additional","affiliation":[{"name":"Sydney Facial Nerve Clinic Chris O'Brien Lifehouse  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Coulson","sequence":"additional","affiliation":[{"name":"Sydney Facial Nerve Clinic Chris O'Brien Lifehouse  Sydney New South Wales Australia"},{"name":"School of Physiotherapy The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gazi","family":"Hussain","sequence":"additional","affiliation":[{"name":"Sydney Facial Nerve Clinic Chris O'Brien Lifehouse  Sydney New South Wales Australia"},{"name":"Department of Plastic, Reconstructive, and Hand Surgery Concord Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan","family":"Ngo","sequence":"additional","affiliation":[{"name":"Sydney Facial Nerve Clinic Chris O'Brien Lifehouse  Sydney New South Wales Australia"},{"name":"Department of Plastic Surgery Liverpool Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Ch'ng","sequence":"additional","affiliation":[{"name":"Sydney Medical School The University of Sydney  Sydney New South Wales Australia"},{"name":"Sydney Facial Nerve Clinic Chris O'Brien Lifehouse  Sydney New South Wales Australia"},{"name":"Institute of Academic Surgery The University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Plastic Surgery Royal Prince Alfred Hospital  Sydney New South Wales 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