International, Multispecialty Expert Consensus on Nomenclature for Facial Paralysis
<b>Background:</b> 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. <b>Study Objectives:</b> Establish a nomenclature consensus for this condition among a group of facial nerve experts. <b>Design Type:</b> Consensus study. <b>Methods:</b> 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. <b>Results:</b> 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%. <b>Conclusions:</b> 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.
Authors
- P. Guerreschi (ORCID: https://orcid.org/0000-0002-2955-5291)
- Jon‐Paul Pepper (ORCID: https://orcid.org/0000-0001-9416-9170)
- Eyal Gur (ORCID: https://orcid.org/0000-0002-2157-1270)
- Matthew Q. Miller (ORCID: https://orcid.org/0000-0003-2470-3897)
- David Chwei‐Chin Chuang (ORCID: https://orcid.org/0000-0002-6117-5600)
- Alison K. Snyder‐Warwick (ORCID: https://orcid.org/0000-0002-9882-4213)
- Jackie Diels (ORCID: https://orcid.org/0000-0001-6678-1039)
- Jacob K. Dey (ORCID: https://orcid.org/0000-0001-8197-2079)
- Babak Azizzadeh (ORCID: https://orcid.org/0000-0002-5607-1022)
- Luis Lassaletta (ORCID: https://orcid.org/0000-0002-8260-4523)
- Michael Klebuc
- Kofi Boahene (ORCID: https://orcid.org/0000-0002-4924-7560)
- Samuel L. Oyer (ORCID: https://orcid.org/0000-0003-4547-5192)
- Laura Hetzler (ORCID: https://orcid.org/0000-0001-8911-1353)
- Tessa A. Hadlock (ORCID: https://orcid.org/0009-0000-3950-4546)
- Samir Mardini (ORCID: https://orcid.org/0000-0002-6434-4676)
- Myriam Loyo (ORCID: https://orcid.org/0000-0003-1590-7054)
- Gregory H. Borschel (ORCID: https://orcid.org/0000-0001-7691-5264)
- Kallirroi Tzafetta (ORCID: https://orcid.org/0000-0002-1468-2394)
- Shai Michael Rozen (ORCID: https://orcid.org/0000-0002-6719-7595)
- Jennifer Kim (ORCID: https://orcid.org/0000-0002-3564-9892)
- Patrick J. Byrne
- D. Labbé
- Scott J. Stephan
- Rachel Baptista
Institutions
- University of North Carolina at Chapel Hill (US)
- Massachusetts Eye and Ear Infirmary (US)
- Our Lady of the Lake Regional Medical Center (US)
- Mayo Clinic (US)
- Harvard University (US)
- Johns Hopkins University (US)
- Oregon Health & Science University (US)
- Vanderbilt University (US)
- Université de Lille (FR)
- University of Michigan (US)
- Tel Aviv Sourasky Medical Center (IL)
- Johns Hopkins Medicine (US)
- Hospital Universitario La Paz (ES)
- Taipei Municipal YangMing Hospital (TW)
- Cleveland Clinic Lerner College of Medicine (US)
- Lille’s Cardiology Hospital (FR)
- St Andrew's Healthcare (GB)
- Plastic Surgery Hospital (CN)
- Southwestern Medical Center (US)
- Methodist Hospital (US)
- Facial Plastics Surgery Associates (US)
- Michigan Medicine (US)
- Mayo Clinic in Arizona (US)
- Sociedade Brasileira de Cirurgia Plástica (BR)
- Associação Brasileira da Batata (BR)
- Stanford Medicine (US)
- Mayo Clinic in Florida (US)
- Laboratoire Saint Martin (FR)
- Southwestern Medical Center (US)
- University of Virginia (US)
- Indiana University – Purdue University Indianapolis (US)
- Louisiana State University Health Sciences Center New Orleans (US)
- The University of Texas Southwestern Medical Center (US)
Publication Details
- Journal
- Facial Plastic Surgery & Aesthetic Medicine
- Published
- 2025-08-28
- DOI
- https://doi.org/10.1177/26893614251363957
- Citations
- 8
- Primary Topic
- Facial Nerve Paralysis Treatment and Research
- Type
- article
- Field-Weighted Citation Impact
- 11.11