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Facial Function Clinic

SERVICE DESCRIPTION:

Facial palsy, while relatively uncommon (1 per 5000), can be a highly disabling condition, resulting in severe cosmetic deformity and functional handicap which, at its worst, can lead to blindness. Fortunately, the more common conditions such as Bell's palsy and Ramsey-Hunt syndrome often fully recover, but can leave between 10 - 40% with permanent problems. In Manchester, one of the commonest causes is secondary to diseases of the skull base (such as acoustic neuroma) and the treatment of these. While some of these improve, recovery can take many months to do so, and is often incomplete. Even a partially recovered palsy leads to distress for patients, such as cosmetic deformity, synkinesis (mass uncontrolled facial movement), spasm and crocodile tears.

A multi-disciplinary facial function clinic with input from ophthalmology (oculoplastics), neurotology, facial plastics and physical therapy offers a complete service, where each discipline provides complimentary therapies. This allows patients the convenience of a single visit and the possibility of a discussion between health professionals to enable the most appropriate therapy for each individual. This is the only such service in the North West and provides a regional tertiary referral centre that compliments the neuro-otology, neurofibromatosis and skull base services.

STAFF:

Consultant Ophthalmic & Oculoplastic Surgeon; Visiting Professor, Liverpool John Moores University - Prof S Ahmed Sadiq
Consultant Otolaryngologist and Skull Base Surgeon - Mr Simon Freeman
Consultant Plastic Surgeon - Mr David Mowatt 
Facial Physiotherapist - Wendy Walker

The facial function team organised the Manchester Facial Palsy Course in 2009. Please click here to see the poster for the event.

TREATMENTS:

Treatment is individualised after discussion between the patient and the members of the facial function team.
This includes (but is not limited to) :
  • eye care to preserve / maintain both vision and ocular comfort
  • reanimation of the eyelids - both static and dynamic
  • reanimation of the lower face - both static and dynamic
  • nerve anastamosis / graft surgery to improve muscle function
  • improvement in facial symmetry
  • physical rehabilitation (after approval from PCT) includes surface electromyography, electrical stimulation, biofeedback and treatment of synkinesis
  • psychological support is initiated by referral as required

Research into different aspects of facial palsy and its psychological effects is ongoing and includes the multidisciplinary approach to patient care, improving symmetry in facial palsy, the impact of treatments / interventions in facial palsy, the impact of treatments / interventions on the psychological effects of facial palsy.

Further information on facial palsy, its management and the review article on the subject, please go to www.theeyespecialist.co.uk

LOCATION:

Please click here for directions to the Eye Hospital.

REFERRAL FOR ASSESSMENT/ TREATMENT:

Please ask your practitioner to send a referral letter to:
Prof Ahmed Sadiq
Manchester Royal Eye Hospital
Oxford Road
Manchester M13 9WH
Tel +44 (0)161 276 8957
fax +44 (0)161 272 6618

USEFUL LINKS:

British Acoustic Neuroma Association http://www.bana-uk.com/
British Association of Plastic Reconstructive & Aesthetic Surgery http://www.bapras.org.uk/
British OculoPlastic Surgery Society http://www.bopss.org

Prof Ahmed Sadiq MBBS DO MRCOphth FRCS FRCOphth DM

sadiqAhmed qualified from the University of London in 1987, and started training in Ophthalmology in London in 1989. He was a registrar and a fellow in Nottingham, and was appointed as Consultant Ophthalmic Surgeon specialising in phacoemulsification and oculoplastics at the Manchester Royal Eye Hospital in December 1998. He has over 50 publications, more than 50 presentations, and a DM (thesis on endonasal laser DCR).

Ahmed's roles at the Central Manchester Foundation Trust & University

Ahmed interviews for the Medical School, and teaches medical and optometry students. He examines medical students, and optometrists for the MOptom. He is a member of the Local Negotiating Committee on behalf of the Manchester Royal Eye Hospital, and is a North West Representative of the Hospital Consultants and Specialists Association. He has raised money for the New Children's Hospital by arranging sponsored events. Ahmed has helped draft new mobile telephone use and consent policies for the Trust.

Ahmed is a member of the General Optical Council's Companies Committee. He is a Member of The RCOphth and a Founder Member of The British Oculoplastic Surgery Society. He is an examiner for the RCOphth as well as part of the Training The Trainers and Microsurgical Skills faculties. Due to his interest in facial palsy management, he is a medical adviser to the British Acoustic Neuroma association. He is a member of the Ophthalmic Qualifications Committee of the British Medical Association.

He is active in research, a journal editor and reviewer. He is a committee member of the British International Doctors Association. He is a medical member of the Appeals Panel of General Medical Council. As well as a journal reviewer, he is a reviewer for Research for Patient Benefit and Map of Medicine.

Outside medicine, Ahmed is a school governor, is involved with medical charities and community finance initiatives, and is co-chair of the Manchester Christian-Muslim Forum.

Publications & Presentations in this subject

Sadiq SA and Downes RN, A clinical algorithm for the management of facial nerve palsy from an oculoplastic perspective, Eye 1998:12:2;219-223

Sadiq SA and Downes RN, Can facial nerve palsy be predicted before acoustic neuroma surgery, 3rd European Skull Base Congress, London 1997 Oral

Sadiq SA and Downes RN, A clinical algorithm for the management of facial nerve palsy from an oculoplastic perspective, 3rd European Skull Base Congress, London 1997 Oral

Sadiq SA, Facial Palsy, CME Journal of Ophthalmology 1998:2:3;66-68
Shah A & Sadiq SA, Facial disfigurement - non-medical aspects, Eye News, Dec/Jan 06, 12, 4; 8-11

Invited Speaker & Co-Chair - Facial Palsy, Asia Pacific Association of Ophthalmic Plastic & Reconstructive Surgery 2007, India

Rahman I & Sadiq SA, Ophthalmic Management of Facial Nerve Palsy - A Review, Survey of Ophthalmology 2007;52;2:121-144

Sadiq SA & Saeed SR, Botulinum Toxin to improve symmetry in facial nerve palsy, XI International Facial Nerve Symposium, Rome 2009

Sadiq SA, Persistent diplopia after botulinum toxin induced comparison - comparison of 2 injection sites, XI International Facial Nerve Symposium, Rome 2009

Sadiq SA, Usmani H, Saeed SR, Walker W & Ross GL, The effectiveness of a combined multi-disciplinary facial function clinic, XI International Facial Nerve Symposium, Rome 2009

Fu L, Rashid A, Bundy C & Sadiq SA, Psychological Distress in People with Disfigurement from Facial Palsy

a. Oral presentation at National Student Research Conference, Manchester Oct 2009
b. Poster presentation at 14th Nottingham Eye Symposium 29/1/10
c. Poster presentation at Congress of the Royal College of Ophthalmologists May 2010
d. Poster presentation at BOPSS 2010

Usman U, Saeed SR & Sadiq SA, Effectiveness of a Multidisciplinary Facial Function Clinic, Poster presentation at BOPSS 2010

Sadiq SA, Saedon H & Saeed SR, BTXA to improve asymmetry in facial palsy, oral presentation at BOPSS 2010

Sadiq SA & Dharmasena A   Superior Rectus Underaction Following Botulinum Toxin Injection To Induce Protective Ptosis - A Comparison Of 2 Techniques

Please click here to read Mr Sadiq's research paper entitled: "Effectiveness of Facial Function Clinic" Eye Oct 2011

Please click here to read Mr Sadiq's research paper entitled: "Psychological distress from Facial Palsy" Eye Oct 2011

Mr David Mowatt FDSRCS, MD, FRCS(Plast)

Mr MowattMr Mowatt is a Consultant Plastic Surgeon at The Christie Hospital in Manchester where he is the clinical lead for Plastic & Reconstructive Surgery. He qualified from Edinburgh University and St George's Hospital, London and undertook specialty training in Yorkshire and Chelmsford following a fellowship in craniofacial surgery and award of a research doctorate at Great Ormond St. Hospital & Institute of Child Health.

He has a large practice in surgical oncology with a special interest in head and neck disease including facial reconstruction and correction of facial palsy.

Mr Mowatt is actively involved in the training of future plastic surgeons and publishes  in the peer reviewed international medical literature.

Mr Simon Freeman MB ChB, BSc Hons, DLO, FRCS (ORL-HNS)

Simon Freeman is a Consultant Otolaryngologist and Skull Base Surgeon at The Central Manchester and Salford Royal Foundation Trusts.

Special interests include skull base surgery, neurotology, otology and cochlear implantation.

Mr Freeman graduated from Manchester University and trained in the North West region. He has undertaken fellowships in Sydney and Manchester in his subspecialist areas. His main research interests are in the management of vestibular schwannomas, brainstem and cochlear Implantation, sudden deafness and Meniere's disease.

Ms Wendy Walker

Wendy Walker trained as a Chartered Physiotherapist in Manchester, and has worked throughout the region. Specialising in Facial Palsy Rehabilitation since 2000, she works at The Lindens Clinic in Sale [http://www.dianafarragher.com/] treating patients with Facial Palsy from a variety of causes.

Areas of expertise include:

  • use of sEMG (surface electromyography) for evaluation of damage to the Facial Nerve
  • Trophic Electrical Stimulation for Facial Palsy
  • sEMG Biofeedback in Facial Palsy
  • Specific interventions for synkinesis


Click here for directions to the Hospital