Timing of Treatment Initiation and Effect on Facial Synkinesis Outcomes-A Retrospective Study.

While facial neuromuscular retraining and chemodenervation are effective treatments for facial synkinesis, it is unclear if clinical outcomes are affected by the timing or sequence of treatment initiation. To compare outcomes between patients with facial synkinesis based on timing of treatment initiation with facial neuromuscular retraining and/or chemodenervation as measured by the Sunnybrook Facial Grading System. Retrospective review of patients with facial synkinesis. Patient data recorded include demographics, clinical information, and Sunnybrook scores. -Tests, analysis of variance, and logistic regression were used for analysis. A total of 78 adult patients were included in our study (73% female; median age 50 years with a range of 18-78 years). Median patient follow-up was 16 months (range of 1-56 months). Patients were divided into three groups based on time between paralysis onset and treatment initiation: <12 months, 12-36 months, and >36 months. The use of facial neuromuscular retraining and chemodenervation improved Sunnybrook scores for all patients. The time between paralysis onset to treatment initiation was not associated with a difference in Sunnybrook scores. The duration of facial palsy prior to initiation of facial neuromuscular retraining and/or chemodenervation was not associated with a difference in synkinesis outcomes as determined by Sunnybrook scores.