Quality of Life Outcomes After Modified Selective Neurectomy for Postfacial Paralysis Synkinesis

Background: Until now, quality of life (QOL) outcomes after modified selective neurectomy for postfacial paralysis synkinesis (PFPS) have not been assessed. Objective: To evaluate QOL outcomes among patients with PFPS who underwent modified selective neurectomy. Methods: The medical records of patients aged >= 18 years with PFPS who underwent modified selective neurectomy during a 6-year period were reviewed. QOL outcomes were measured using the Facial Clinimetric Evaluation (FaCE) scale and Synkinesis Assessment Questionnaire (SAQ). Results: At <1 year after selective neurectomy, there was improvement in mean SAQ (from 26.6 [95% confidence interval {CI}, 23.7-29.5] to 21.4 [95% CI, 19.5-23.3]; p < 0.0001). Mean FaCE scores improved (from 47.1 [95% CI, 43.6-50.6] to 62.6 [95% CI, 58.7-66.5]; p < 0.0001), with improvements in all subscores except lacrimal control scores (from 61.7 [95% CI, 52.6-70.9] to 62.2 [95% CI, 53.6-70.9]; p = 0.91). At >1 year after surgery, there was improvement in mean SAQ score (from 28.8 [95% CI, 26.0-31.6] to 23.4 [95% CI, 21.0-25.7]; p < 0.0001). Mean FaCE scores improved (from 45.9 [95% CI, 41.6-50.3] to 59.4 [95% CI, 53.6-65.2]; p < 0.0001), with improvements in all subscores except eye comfort and lacrimal control (from 52.4 [95% CI, -40.8-64.0] to 56.8 [95% CI, 45.5-68.0]; p = 0.36), and lacrimal control scores worsened (from 68.0 [95% CI, 56.7-79.2] to 56.3 [95% CI, 44.8-67.7]; p = 0.023). Conclusions: Modified selective neurectomy results in QOL improvements in patients with PFPS.