{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:12:06Z","timestamp":1787069526008,"version":"build-2736575974"},"reference-count":13,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Facial Plastic Surgery &amp; Aesthetic Medicine"],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Facial synkinesis can lead to unintended activation of perinasal muscles, contributing to dynamic nasal obstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine whether targeted botulinum toxin injections, compared to no treatment, reduce new ipsilateral nasal obstruction symptoms in patients with facial synkinesis, as measured by patient-reported outcomes and the Nasal Obstruction Symptom Evaluation (NOSE) scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review was conducted of patients presenting with ipsilateral nasal obstruction and synkinesis at a multidisciplinary facial nerve clinic. Botulinum toxin (2\u20132.5 units) was injected into the supra-alar nasalis and depressor septi muscles. Symptom improvement was assessed at 4 weeks using patient-reported outcomes and the NOSE scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 99 treated synkinetic patients, 23 (23.5%) reported new-onset nasal obstruction. Following chemodenervation, 74% experienced symptom relief, 4% had no improvement, and 22% were indeterminate. NOSE scores significantly improved from a mean of 44.86 to 28.93, with a mean difference of 15.93 (95% confidence interval: 2.86\u201329.00).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Botulinum toxin injections targeting the perinasal musculature significantly improved nasal obstruction symptoms in patients with facial synkinesis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/26893614251372080","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T17:58:29Z","timestamp":1759255109000},"page":"431-436","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Role of Perinasal Musculature in Ipsilateral Nasal Obstruction During Synkinesis Progression"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9552-6593","authenticated-orcid":false,"given":"Carley","family":"Boyce","sequence":"first","affiliation":[{"name":"Department of Otolaryngology and Division of Facial Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Division of Facial Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reed","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Division of Facial Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhide","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Division of Facial Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"MacDowell","sequence":"additional","affiliation":[{"name":"Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura T.","family":"Hetzler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Division of Facial Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA."},{"name":"Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,28]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/019459988509300202"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10605"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/fpsam.2020.0610"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1090820X10373357"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2024.07.018"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199807000-00014"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-020-01693-3"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neucli.2024.103019"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2003.09.016"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.3109\/09638280903514697"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/IOP.0000000000000086"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2013.344"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12859"}],"container-title":["Facial Plastic Surgery &amp; 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