title: Platysmectomy: an effective intervention for facial synkinesis and hypertonicity.
abstract: OBJECTIVE
  To describe a procedure to permanently address platysmal synkinesis and hypertonicity and to report changes in quality of life associated with platysmectomy using the Facial Clinimetric Evaluation instrument.
  
  
  METHODS
  Chemodenervation significantly relieves platysmal synkinesis in almost all patients with significant face and neck synkinesis associated with dynamic facial expressions. We recently began to offer platysmectomy as part of a permanent solution to chronic superficial torticollis-like neck symptoms. For a 10-month period, 24 patients underwent the procedure, and preoperative and postoperative Facial Clinimetric Evaluation data were obtained from 21 patients (88%).
  
  
  RESULTS
  In 19 patients, platysmectomy was performed using local anesthesia without sedation. In the remaining 5 patients, platysmectomy was performed using general anesthesia concurrent with free gracilis transfer for smile reanimation. No intraoperative or postoperative complications occurred. Overall, the patients' quality of life significantly improved after platysmectomy (P = .02).
  
  
  CONCLUSIONS
  Platysmectomy is straightforward and seems effective in treating neck synkinesis associated with chronic hypertonic platysmal activity.
authors.affiliation: Facial Nerve Center, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, 243 Charles St., Boston, MA 02114, USA. douglas_henstrom@meei.harvard.edu
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Henstrom
authors.forename: Juan S
authors.initials: JS
authors.lastname: Malo
authors.forename: Mack L
authors.initials: ML
authors.lastname: Cheney
authors.forename: Tessa A
authors.initials: TA
authors.lastname: Hadlock
mesh_terms: D000293:Adolescent; D000328:Adult; D005145:Face / Q000503:physiopathology; D005152:Facial Muscles / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009122:Muscle Hypertonia / Q000601:surgery*; D009334:Neck Muscles / Q000503:physiopathology* / Q000601:surgery*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012904:Smiling / Q000502:physiology; D046608:Synkinesis / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult