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Synkinesis refers to involuntary muscular movements that occur in association with voluntary contraction of other muscle groups. Oculonasal synkinesis, described by Guyuron in 1994 1, is a rare phenomenon triggered by blinking: a paroxysmal contraction of the compressor narium minor leads to movements of the alar complex. Several authors have tried to focus on the etiology of this rare phenomenon but its real origin is still unclear; postoperative, traumatic, as well as congenital causes are considered to be responsible 2-4. Two muscles are essentially involved into oculonasal synkinesis, the compressor narium minor and the orbicularis oculi. The first one is composed of a small group of fibers that origin from the genua of the alar cartilage and the lateral crura and go straight along the fibers of the anterior dilator naris to the nostril skin and the nasal tip. Contraction of this muscle causes a depression of the nasal cavity. The compressor narium minor seems to have 2 functions: it produces.

eccentric and concentric movements of the tip, and it compresses the nostril. A great anatomic variability has largely been described for this area of the face, but authors seem to converge on the irregular connections among the temporal and zygomatic branches of the facial nerve and the buccal branch, as implicated at the origin of this particular phenomenon. Oculonasal synkinesis was identified in a 52-year-old female patient who underwent nasal surgery for a BCC excision; she did not present chronic or other considerable diseases. The loss of substance was closed by first intention and the postoperative histological examination revealed a total excision. The phenomenon was not noticed at the time of the first visit or before surgery. The patient was evaluated two weeks, one and three months after the procedure (Video 1. 52-year-old female patient presenting oculonasal synkinesis after BCC resection. Clinical evaluation 2 weeks and 3 months after surgery). To authors’ knowledge, this study is the first to provide video documentation of a patient presenting oculonasal synkinesis after surgical oncologic excision. Our findings underscore the importance of careful preoperative clinical exams, preferably including an accurate video recording.


Authors fully disclose any existing or potential conflicts of interest of a financial, personal or any other nature that could affect or bias their research.


None of the above-mentioned authors has a financial interest or sponsorship, or funding, or conflict of interest in any of the products, devices, or drugs mentioned in this manuscript. All the authors declare and confirm that no financial support or benefit have been received by the first or any co-author, by any member of his and their immediate families or any individual or entity with whom or with which, He or They have a relationship from any commercial source, which is related directly or indirectly to the scientific work, which is reported on in the article. All the authors approve the codes obtained by their ethical committee about the present research.


GG: A, D, DT, S, W


SC: D, DT, S



MC: D, DT, S


A: conceived and designed the analysis

D: collected the data

DT: contributed data or analysis tool

S: performed the analysis

W: wrote the paper

O: other contribution (specify contribution in more detail)


The study was approved by the Local Ethical Committee. All followed procedures were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent was obtained from all patients for being included in the study. Patients also signed an informed consent for their pictures and the video included in the study.


  1. Guyuron B, Bokhari F, Galloway D. Oculonasal synkinesis. Plast Reconstr Surg. 1994;94:25125-3. doi:
  2. Guarro G, Brunelli F, Rasile B. Oculonasal synkinesis: video report and surgical solution of a rare phenomenon. Aesthet Surg J. 2017;37:879-883. doi:
  3. Barone M, Salzillo R, Cassotta G. Unilateral oculonasal synkinesis after rhinoplasty. Aesthetic Plast Surg. 2022;46:137-138. doi:
  4. Torrado L, Hamilton G, Brodsky M. Congenital oculonasal synkinesis. J Neuroophthalmol. 2019;39:127-128. doi:


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Giuseppe Guarro - Department of Plastic and Reconstructive Surgery, Azienda USL Umbria 1, Perugia, Italy

Romano Maffia - Department of Plastic and Reconstructive Surgery, Azienda USL Umbria 1, Perugia, Italy

Sara Carella - Department of Plastic and Reconstructive Surgery, Azienda USL Umbria 1, Perugia, Italy

Lavinia Ceccaccio - Department of Plastic and Reconstructive Surgery, Azienda USL Umbria 1, Perugia, Italy

Andrea Calabrese - Department of Plastic and Reconstructive Surgery, Azienda USL Umbria 1, Perugia, Italy

Marino Cordellini - Department of Plastic and Reconstructive Surgery, Azienda USL Umbria 1, Perugia, Italy

How to Cite
Guarro, G., Maffia, R., Carella, S., Ceccaccio, L., Calabrese, A. and Cordellini, M. 2023. Oculonasal synkinesis after BCC excision: a rarity in a rarity. Plastic Reconstructive and Regenerative Surgery. 1, 3 (Feb. 2023), 127–128. DOI:
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