International, Multispecialty Expert Consensus on Nomenclature for Facial Paralysis

Document Type

Article

Publication Date

8-25-2025

Publication Title

Facial Plastic Surgery and Aesthetic Medicine

Abstract

Background: Variable terminology is used in the literature to describe facial synkinesis and hypertonicity following incomplete recovery from facial paralysis and its associated medical and surgical treatments. Study Objectives: Establish a nomenclature consensus for this condition among a group of facial nerve experts. Design Type: Consensus study. Methods: Using modified Delphi methodology, an international, multidisciplinary group of facial nerve experts reviewed the terminology for the name of the clinical condition and treatments of interest. Online surveys and a virtual discussion were performed to establish consensus, defined a priori as agreement by 80% of the group. Results: Twenty-five facial nerve experts established consensus after three Delphi rounds. Consensus terminology for the condition is “facial synkinesis” with 84% agreement. Medical treatment is termed “chemodenervation” with 100% agreement. Surgical treatments including “selective facial neurectomy,” “selective facial neurotomy,” “selective facial myectomy,” and “selective facial myotomy,” were defined and reached agreement of 100%. Conclusions: This international group of facial nerve experts has recommended standardized nomenclature for the condition of facial synkinesis and its various treatments. While “facial synkinesis” reached consensus as the preferred term, some experts noted it may insufficiently describe the full clinical spectrum, which includes muscle hypertonicity, weakness, and spontaneous twitching.

First Page

408

Last Page

415

PubMed ID

40876002

Volume

27

Issue

5

Publisher

Mary Ann Liebert, Sage

Rights

Copyright 2025, American Academy of Facial Plastic and Reconstructive Surgery, Inc. © 2025 Sage Publications or its affiliates, licensors, or contributors. All rights reserved, including those for text and data mining and training of large language models, artificial intelligence technologies, or similar technologies.

Link to Full Text

Share

COinS