N Bylund1, D Jensson2, S Enghag1, T Berg3, E Marsk4, M Hultcrantz4, N Hadziosmanovic5, A Rodriguez-Lorenzo2, L Jonsson1. 1. Department of Surgical Sciences, Otorhinolaryngology and Head and Neck Surgery, Uppsala University, Uppsala, Sweden. 2. Department of Surgical Sciences, Plastic and Maxillofacial Surgery, Uppsala University, Uppsala, Sweden. 3. Department of Plastic and Reconstructive Surgery and the Institute for Surgical Research, Oslo University Hospital Rikshospitalet, Oslo, Norway. 4. Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden. 5. Uppsala Clinical Research Centre, Uppsala, Sweden.
Abstract
OBJECTIVES: To study the development of synkinesis in Bell's palsy. Frequency, severity, gender aspects and predictors were analysed. DESIGN: Data from the randomised controlled Scandinavian Bell's palsy trial including 829 patients. MAIN OUTCOME MEASURES: Frequency and severity of synkinesis at 12 months were the main outcome measures. Mean Sunnybrook synkinesis scores, voluntary movement scores and composite scores between 6 and 12 months were compared. RESULTS: In 743 patients with a 12-month follow-up, synkinesis frequency was 21.3%. There was no gender difference. Synkinesis was moderate to severe in 6.6% of patients. Those with synkinesis at 6 months had a synkinesis score of 4.1 (±2.8 sd), which increased to 4.7 (±3.2) (P = 0.047) at 12 months (n = 93). Sunnybrook composite score at 1 month was the best predictor for synkinesis development with receiver operating characteristics and area under the curve (AUC) 0.87. Risk for synkinesis increased with a lower Sunnybrook composite score. Furthermore, at 1 month, symmetry of voluntary movement had higher predictive value for synkinesis than resting symmetry with AUC 0.87 and 0.77, respectively. Gentle eye closure and open-mouth smile were the only independent significant predictive items (AUC 0.86). CONCLUSIONS:Moderate-to-severe synkinesis was present in 6.6% of patients. The mean synkinesis score increased between 6 and 12 months, and outcome should therefore be evaluated after at least 12 months. Sunnybrook composite score and symmetry of voluntary movement at 1 month were good predictors for synkinesis.
RCT Entities:
OBJECTIVES: To study the development of synkinesis in Bell's palsy. Frequency, severity, gender aspects and predictors were analysed. DESIGN: Data from the randomised controlled Scandinavian Bell's palsy trial including 829 patients. MAIN OUTCOME MEASURES: Frequency and severity of synkinesis at 12 months were the main outcome measures. Mean Sunnybrook synkinesis scores, voluntary movement scores and composite scores between 6 and 12 months were compared. RESULTS: In 743 patients with a 12-month follow-up, synkinesis frequency was 21.3%. There was no gender difference. Synkinesis was moderate to severe in 6.6% of patients. Those with synkinesis at 6 months had a synkinesis score of 4.1 (±2.8 sd), which increased to 4.7 (±3.2) (P = 0.047) at 12 months (n = 93). Sunnybrook composite score at 1 month was the best predictor for synkinesis development with receiver operating characteristics and area under the curve (AUC) 0.87. Risk for synkinesis increased with a lower Sunnybrook composite score. Furthermore, at 1 month, symmetry of voluntary movement had higher predictive value for synkinesis than resting symmetry with AUC 0.87 and 0.77, respectively. Gentle eye closure and open-mouth smile were the only independent significant predictive items (AUC 0.86). CONCLUSIONS: Moderate-to-severe synkinesis was present in 6.6% of patients. The mean synkinesis score increased between 6 and 12 months, and outcome should therefore be evaluated after at least 12 months. Sunnybrook composite score and symmetry of voluntary movement at 1 month were good predictors for synkinesis.
Authors: Josef Georg Heckmann; Peter Paul Urban; Susanne Pitz; Orlando Guntinas-Lichius; Ildikό Gágyor Journal: Dtsch Arztebl Int Date: 2019-10-11 Impact factor: 5.594
Authors: Andreas Kehrer; Marc Ruewe; Natascha Platz Batista da Silva; Daniel Lonic; Paul Immanuel Heidekrueger; Samuel Knoedler; Ernst Michael Jung; Lukas Prantl; Leonard Knoedler Journal: Diagnostics (Basel) Date: 2022-07-07