How Best to Manage Facial Synkinesis?

Purpose of Review: Facial synkinesis is a sequela of facial nerve injury that results in involuntary facial movement occurring simultaneously with volitional facial movement. Inability to control facial movement has functional and psychological consequences and can be socially isolating. This review discusses the involved facial nerves and musculature, evaluation of the synkinetic face, and different treatment options. Recent Findings: We reviewed the literature for advancements and outcomes in assessment, rehabilitation, and non-surgical and surgical treatments for facial synkinesis while highlighting anatomical correlates and movement patterns of commonly affected facial musculature. Summary: Understanding facial muscular anatomy, including the intended vectors of movement, guides appropriate therapeutic intervention and improves outcomes. Chemodenervation and rehabilitation continue to be the main treatment strategy for facial synkinesis. In select cases, other techniques, such as selective neurolysis, selective myectomy, nerve grafting, or free muscle transfer, are also available.