Ep. 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. 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. --- SHOW NOTES 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