{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:40:08Z","timestamp":1792118408897,"version":"4.4.0"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,12,22]],"date-time":"2016-12-22T00:00:00Z","timestamp":1482364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100007051","name":"Uppsala Universitet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007051","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2017,6]]},"abstract":"\n Objectives<\/jats:title>\n To study the development of synkinesis in Bell's palsy. Frequency, severity, gender aspects and predictors were analysed.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Data from the randomised controlled Scandinavian Bell's palsy trial including 829 patients.<\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n Frequency and severity of synkinesis at 12 months were the main outcome measures. Mean Sunnybrook synkinesis scores, voluntary movement scores and composite scores between 6 and 12 months were compared.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In 743 patients with a 12\u2010month follow\u2010up, synkinesis frequency was 21.3%. There was no gender difference. Synkinesis was moderate to severe in 6.6% of patients. Those with synkinesis at 6 months had a synkinesis score of 4.1 (\u00b12.8\n sd<\/jats:sc>\n ), which increased to 4.7 (\u00b13.2) (\n P<\/jats:italic>\n = 0.047) at 12 months (\n n<\/jats:italic>\n = 93). Sunnybrook composite score at 1 month was the best predictor for synkinesis development with receiver operating characteristics and area under the curve (\n AUC<\/jats:styled-content>\n ) 0.87. Risk for synkinesis increased with a lower Sunnybrook composite score. Furthermore, at 1 month, symmetry of voluntary movement had higher predictive value for synkinesis than resting symmetry with\n AUC<\/jats:styled-content>\n 0.87 and 0.77, respectively. Gentle eye closure and open\u2010mouth smile were the only independent significant predictive items (\n AUC<\/jats:styled-content>\n 0.86).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Moderate\u2010to\u2010severe synkinesis was present in 6.6% of patients. The mean synkinesis score increased between 6 and 12 months, and outcome should therefore be evaluated after at least 12 months. Sunnybrook composite score and symmetry of voluntary movement at 1 month were good predictors for synkinesis.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/coa.12799","type":"journal-article","created":{"date-parts":[[2016,11,24]],"date-time":"2016-11-24T02:42:58Z","timestamp":1479955378000},"page":"673-680","source":"Crossref","is-referenced-by-count":60,"title":["Synkinesis in Bell's palsy in a randomised controlled trial"],"prefix":"10.1111","volume":"42","author":[{"given":"N.","family":"Bylund","sequence":"first","affiliation":[{"name":"Department of Surgical Sciences, Otorhinolaryngology and Head and Neck Surgery Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Jensson","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Plastic and Maxillofacial Surgery Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Enghag","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Otorhinolaryngology and Head and Neck Surgery Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Berg","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery and the Institute for Surgical Research Oslo University Hospital Rikshospitalet Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Marsk","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Hultcrantz","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Hadziosmanovic","sequence":"additional","affiliation":[{"name":"Uppsala Clinical Research Centre Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Rodriguez\u2010Lorenzo","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Plastic and Maxillofacial Surgery Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Jonsson","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Otorhinolaryngology and Head and Neck Surgery Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,12,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197911000-00020"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1075840"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e3181d8d84d"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70221-7"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-59989670206-1"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23210"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459988509300202"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2012.513"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000905"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e3180412460"},{"key":"e_1_2_9_12_1","first-page":"93","article-title":"Occurrence of sequelae in Bell's palsy","volume":"446","author":"Yamamoto E.","year":"1988","journal-title":"Acta Otolaryngol. 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