Oculonasal Synkinesis: Video Report, Anatomic Discussion and Etiological Analysis of a Rare Phenomenon.

TITLE: Oculonasal Synkinesis: video report, anatomic discussion and etiological analysis of a rare phenomenon. 

INTRODUCTION: Oculonasal Synkinesis is a rare phenomenon linked to involuntary movements in relation to the contraction of different muscular units. The etiology of this condition remains unclear, although the role of irregular connections between the temporal, zygomatic and buccal branches of the facial nerve, which innervate the orbicularis oculi and compressor narium minor muscles respectively, appears to be crucial. This study offers accurate video documentation on two cases, also suggesting the pathway to obtain a good surgical correction with both intra-nasal and open rhinoplasty.

 

METHODS. This report focused on Oculonasal Synkinesis noticed in two female patients. The average age was 27,5; one of the subjects showed bilateral synkinesis, the other one on the left side only.

 

RESULTS. Authors adopted two surgical approaches to correct the described condition: the patient who presented bilateral Oculonasal Synkinesis underwent open rhinoplasty, for the one who had the contraction only on the left side an endonasal procedure was preferred.

 

CONCLUSIONS. Oculonasal Synkinesis represents a rare phenomenon. This report focuses on the relevance of a well-conducted preoperative observation: patients who exhibit this particular condition could not discover this unusual muscular movement before rhinoplasty and could wrongly attribute it to the surgical procedure. 

 

 

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4. Bajaj-Luthra A, VanSwearingen JM, Thornton RH. Quantitation of Patterns of Facial Movement in Patients with Ocular to Oral Synkinesis. Plast and Reconstr Surg. 1998;101: 1473.

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Figure 1. Irregular anatomic connections between the orbicularis oculi and compressor narium minor can produce oculonasal synkinesis.

Figure 2. The intrinsic nasal musculature.