BackTable / ENT / Podcast / Episode #151
Navigating Synkinesis: From Diagnosis to Comprehensive Care
with Dr. Shiayin Yang
In this episode, host Dr. Ashley Agan discusses management of synkinesis with Dr. Shiayin (Shi) Yang, facial plastic surgeon at Vanderbilt University Medical Center.
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BackTable, LLC (Producer). (2023, December 26). Ep. 151 – Navigating Synkinesis: From Diagnosis to Comprehensive Care [Audio podcast]. Retrieved from https://www.backtable.com
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Podcast Contributors
Dr. Shiayin Yang
Dr. Shiayin Yang is an assistant professor of facial plastic and reconstructive surgery with Vanderbilt University in Nashville, Tennessee.
Dr. Ashley Agan
Dr. Ashley Agan is an otolaryngologist in Dallas, TX.
Synopsis
The surgeons begin by defining synkinesis, a condition in which voluntary facial muscle movement triggers involuntary contraction of other facial muscles. Though the pathophysiology of synkinesis remains incompletely understood, damage to and aberrant “rewiring” of the facial nerve is thought to trigger these symptoms. Causes of synkinesis include Bell’s Palsy, facial tumors, and intra-operative injury. Dr. Yang explains the importance of appropriate patient counseling, especially given the misperception that synkinesis is a “disease of vanity.” The discussion then transitions to treatment options, including physical therapy, Botox injections, and surgical intervention (including myectomy and selective neurectomy). The podcast finishes with Dr. Yang’s insights into the mental health impact of synkinesis.
Timestamps
00:00 – Introduction
02:26 – Understanding Synkinesis
05:08 – Common Patient Presentations
06:11 – Importance of Early Treatment and Patient Education
07:48 – Referral and Timeliness of Treatment
09:35 – Pathophysiology of Nerve Rewiring
12:11 – Workup and Diagnosis
17:57 – Treatment Options: Botox Therapy
25:51 – Treatment Options: Surgical Interventions
30:31 – Long-term Management and Expectations
33:27 – Eye Protection in Facial Paralysis
37:16 – Mental Health Impact of Synkinesis
38:27 – Conclusion and Contact Information
Resources
Dr. Yang’s Vanderbilt University Medical Center profile:
https://search.vanderbilthealth.com/doctors/yang-shiayin
Transcript Preview
[Dr. Shiayin Yang]
I think improving the awareness [of synkinesis] for everyone will make such a big difference. There's so much we can do. Aside from just the functional aspect of it, there's a huge psychological component too, because patients just tell me, "I don't go out, I don't eat, I don't see my friends, I quit my job." It's just heart-wrenching because there's so much that we can do for these patients, but the awareness is just not there. The understanding of what can be done, we just need to help educate people so that we can provide the treatments that they need.
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.