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BackTable / ENT / Podcast / Episode #188
Surgical Management of Synkinesis & Static Procedures for Flaccid Facial Palsy
with Dr. Shiayin Yang
Facial nerve injury affects each patient in a unique way. Accordingly, surgical treatment of facial paralysis must be meticulously planned and personalized. In this episode, Dr. Shiayin Yang, Associate Professor of Otolaryngology at Vanderbilt University, addresses management of synkinesis and static procedures for flaccid facial palsy with host Dr. Ashley Agan.
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BackTable, LLC (Producer). (2024, August 27). Ep. 188 – Surgical Management of Synkinesis & Static Procedures for Flaccid Facial Palsy [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
First, Dr. Yang reviews the difference between flaccid and non-flaccid (including synkinetic) facial paralysis. She describes her approach to facial paralysis, which includes clarifying the patient’s diagnosis and thoroughly examining the facial nerve function. Dr. Yang then transitions the conversation to surgical solutions, emphasizing dual goals of restoring symmetry and function. She divides her discussion to first tackle synkinesis and then static procedures for flaccid paralysis. Procedures discussed include Botox, brow lift, blepharoplasty, myectomy, and neurectomy as well as lower eyelid and midface procedures and temporalis tendon transfer. While surgical approaches to the two conditions differ, eye protection represents an important theme throughout. The episode concludes with Dr. Yang’s pearls for approaching these complex surgical problems and a reminder of how facial paralysis affects patients’ emotional health.
Timestamps
00:00 - Introduction
02:36 - Understanding Flaccid & Non-Flaccid Facial Paralysis
07:13 - Botox for Facial Synkinesis
12:38 - History-Taking & Physical Exam in Facial Paralysis
15:07 - Surgical Management of Synkinesis
30:47 - Patient Counseling and Motivation
32:47 - Static Procedures for Flaccid Facial Palsy
37:26 - Nuances of Peri-Ocular Procedures
43:42 - Lower Eyelid & Midface Considerations
53:00 - Dynamic Surgery Options
56:56 - Final Surgical Pearls
Resources
Dr. Shiayin Yang’s Vanderbilt University Profile: https://www.vanderbilthealth.com/doctors/yang-shiayin
BackTable ENT Episode 151- Navigating Synkinesis: From Diagnosis to Comprehensive Care with Dr. Shiayin Yang
https://open.spotify.com/episode/1JucnHB8tNC5qRW6u82ie8?si=ba729d3f3e164d6f
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.
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