Skip to main content
AAO-HNSF 2026 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.

Scientific Oral Presentation

Facial Plastic and Reconstructive Surgery

Development of Facial Synkinesis and Mass-movement After Masseteric-facial and Hypoglossal-facial Nerve Transfers: A Systematic Review

Sunday, October 18, 2026
10:06 AM - 10:12 AM PT
Location: 404A

    Presenting Author(s)

  • Amy Wang, BA

    Medical Student
    University of Texas Medical Branch
    Katy, TX, United States

    • Co-Author(s)

  • Jennifer A. Kong, BA

    Medical Student
    Vanderbilt University School of Medicine
    Nashville, TN, United States

  • ND

    Nicole G. Desisto, MD

    Resident Physician
    Vanderbilt University Medical Center
    Nashville, Tennessee, United States

  • SS

    Scott J. Stephan, MD

    Scott Stephan
    Vanderbilt University Medical Center
    Nashville, TN, United States

  • Priyesh N. patel, MD

    Priyesh Patel
    Vanderbilt Univeristy Medical Center
    Nashville, Tennessee, United States

    • Senior Author(s)

  • sy

    shiayin F. yang, MD

    Shiayin Yang
    Vanderbilt University Medical Center
    Nashville, Tennessee, United States

Disclosure(s):
Amy Wang, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Neural reanimation procedures including masseteric-facial (5-7) and hypoglossal-facial (12-7) nerve transfers restore facial movement following flaccid facial paralysis. However, post-reanimation synkinesis is a common sequela, characterized by the development of undesired co-contraction of facial muscles with voluntary movement. To date, no reports specifically assess facial synkinesis or mass movement outcomes after 5-7, 12-7, or dual nerve transfer procedures.

Methods: PubMed, Scopus, and ProQuest were searched for case series or cohort studies with quantifiable synkinesis or mass movement outcomes after 5-7, 12-7, or dual nerve transfer for treatment of flaccid facial paralysis. Two reviewers screened 221 studies according to PRISMA guidelines. Data collected included nerve repair technique, paralysis duration, time to first movement, follow-up length, and outcomes related to synkinesis and mass movement.

Results: A total of 32 studies were analyzed including 16 studies on 12-7 transfers (50%), 6 studies on 5-7 transfers (19%), 6 studies on dual nerve transfers (19%), and 4 studies with multiple repair types (13%). There were 685 patients, of which 457 (67%) had 12-7 transfers, 100 (15%) had 5-7 transfers, and 128 (19%) had dual nerve transfers. Most descriptions of synkinesis or mass movement were mild and non-debilitating. Most studies (n=17, 53%) reported synkinesis outcomes categorically (Y/N) and numerically (number of cases). From these studies, 64% (n=21/33) of 5-7 patients and 77% (n=202/262) of 12-7 patients were reported to develop synkinesis. The remainder of studies reported synkinesis outcomes using established scales (n=15, 47%). The Facial Clinimetric Evaluation scale and Sunnybrook Facial Grading Scale were most often used to evaluate synkinesis (each n=6, 40%).

Conclusions: This study represents the first comprehensive analysis comparing facial synkinesis and mass movement outcomes following 5-7, 12-7, and dual neural reanimation procedures. Post-reanimation synkinesis was often mild but occurred frequently, appearing at much higher rates than current estimations.