Software‐based video analysis of functional outcomes of face transplantation

Fischer, Sebastian; Diehm, Yannick; Dorante, Miguel I.; Kotsougiani, Dimitra; Kueckelhaus, Maximilian; Alhefzi, Muayyad; Bueno, Ericka M.; Pomahac, Bohdan

doi:10.1002/micr.30360

Cited by 13 publications

(20 citation statements)

References 26 publications

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“…Lantieri et al published their long‐term results with their seven patients and showed that when the orbicularis oris muscle recovered, it allowed complete function of the mouth with oral competence 18 . The Boston team has been able to show that mouth opening and smiling functions both improved the most, comparable to those of the normal population 19 . In our two patients, we are able to show good facial and lip muscle recovery similar to previous reports.…”

Section: Discussionsupporting

confidence: 84%

“…While some studies report restoration of swallowing after FT, 17,19 there does not appear to be a detailed analysis comparing pre-transplant ability to masticate and swallow to recovery of swallowing after FT. With FT patients, the problems regarding swallowing are usually related to the initial oral phase of swallowing, bolus control, and mastication because the larynx and lower parts of the GI-tract are often unaffected by the initial trauma. Our first patient recovered to practically normal swallowing while the second patient still relies on pureed and liquid-like foods.…”

Section: Swallowingmentioning

confidence: 99%

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Speech Characteristics and Oromyofunctional Outcomes in Two Bimaxillary Face Transplantation Patients in Helsinki

et al. 2021

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Objectives/Hypothesis: Facial functional restoration is one of the main goals in face transplantation. We report the oromyofacial function outcomes of two bimaxillary face transplantation (FT) patients in Helsinki.Study design: Outcome Study. Methods: Two male patients, aged 34 and 59, had severe functional facial disabilities following self-inflicted gunshot injuries sustained to their mid and lower faces several years earlier. Both underwent tooth-bearing maxillomandibular face transplantation in 2016 and 2018. We collected data regarding speech, swallowing, sensory recovery, motor recovery, and olfaction prior to transplantation. Patient charts were reviewed from the follow-up period of 4 and 2 years, respectively.Results: Speech intelligibility, acceptability, and articulation continued to improve during follow-up for both patients. Voice quality and resonance were mainly normal at last follow-up. Swallowing improved once lip occlusion was regained, with only minor aspiration evident on videofluorography. Both patients had significant improvement in facial mimic muscle function after FT. The first patient who only had buccal sensory nerves connected has only recovered protective facial sensation, whereas our second patient with buccal, infraorbital, and alveolar nerves connected has almost complete facial two-point discrimination.Conclusion: Both patients have regained satisfactory facial sensory and motor function. Sensory recovery seems to be faster and more precise if multiple sensory nerve coaptations are performed. Swallowing and speech have continued to improve over time although not reaching the level of the normal population. We demonstrate how speech-corrective surgery can safely be performed in a FT patient and can improve speech recovery.

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Section: Discussionsupporting

confidence: 84%

Section: Swallowingmentioning

confidence: 99%

Speech Characteristics and Oromyofunctional Outcomes in Two Bimaxillary Face Transplantation Patients in Helsinki

et al. 2021

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“…In addition, Nelson et al 27 showed that the use of photographs improved patient care for review of healing or complications in burn therapy. Also, Fischer et al 28 demonstrated video analysis to negotiate inaccuracy and subjectivity in outcome analysis of facial movements and functions after face transplant. Likewise, video allows for transparency in post-ED decision-making, which might be the first step to ensure the quality of care using ED, a quite new method in burn wound care.…”

Section: Discussionmentioning

confidence: 99%

Enzymatic Debridement for Burn Wound Care: Interrater Reliability and Impact of Experience in Post-intervention Therapy Decision

Siegwart

Diehm

Kotsougiani-Fischer

et al. 2020

Journal of Burn Care &Amp; Research

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Enzymatic debridement (ED) has become a reliable tool for eschar removal. Although ED application is simple, wound bed evaluation and therapy decision post-intervention are prone to subjectivity and failure. Experience in ED might be the key, but this has not been proven yet. The aim of this study was to assess interrater reliability (IR) in post-intervention wound bed evaluation and therapy decision as well as the impact of experience. In addition, the authors introduce video assessment as a valuable tool for post-ED decision-making and education. A video-based survey was conducted among physicians with various experiences in ED. The survey involved multiple-choice and 5-point Likert scale questions about professional status, experience in ED, confidence in post-ED wound bed evaluation, and therapy decision. Subsequently, videos of 15 mixed pattern to full-thickness burns immediately after removal of the enzyme complex were demonstrated. Participants were asked for evaluation of each burn wound, including bleeding pattern and consequent therapy decision. IR ≥ 80% was considered as a consensus. Responses were stratified according to participants’ experience in applying ED (<10, 10–19, 20–49, and ≥50 applications). IR was assessed by chi-square test (raw agreement [RA]; ≥80% was considered as a consensus) and by calculation of Krippendorff’s alpha. In addition, expert consensus for therapy decision was compared with the actual clinical course of each shown patient. Last, participants were asked for their opinion on video as an assessment tool for post-ED wound bed evaluation, decision-making, and training. Thirty-one physicians from 11 burn centers participated in the survey. The overall consensus (raw agreement [RA] ≥ 80%) in post-ED wound bed evaluation and therapy decision was achieved in 20 and 40%, respectively. Krippendorff’s alpha is given by 0.32 (95% confidence interval: 0.15, 0.49) and 0.31 (95% confidence interval: 0.16, 0.47), respectively. Subgroup analysis revealed that physicians with high experience in ED achieved significantly more consensus in post-intervention wound bed evaluation and therapy decision compared with physicians with moderate experience (60 vs 13.3%; P = .02 and 86.7 vs 33.3%; P = .04, respectively). Video analysis was considered a feasible (90.3%) and beneficial (93.5%) tool for post-intervention wound bed evaluation and therapy decision as well as useful for training purposes (100%). Reliability of wound bed evaluation and therapy decision after ED depends on the experience of the rating physician. Video analysis is deemed to be a valuable tool for ED evaluation, decision-making, and user training.

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“…Existió una diferencia neta de $26 247 dolares, lo que implica un aumento de 12.7% al recurrir al TF, frente a las técnicas convencionales. Lo anterior teniendo en cuenta, que no se incluyeron los costos asociados a la inmunosupresión de por vida requerida por el paciente 42,43 .…”

Section: Costosunclassified

Trasplante facial generalidades

Cárdenas¹,

Fernández²,

Arteaga³

et al. 2020

Rev Medicas UIS

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El trasplante facial es un alotrasplante compuesto vascularizado que busca la reconstrucción de defectos masivos faciales permitiendo la reinserción social del receptor, generando un impacto positivo sobre su calidad de vida. El objetivo de este artículo fue realizar una revisión de la literatura sobre generalidades del trasplante facial, enfocándose en los cuidados pre, intra y postoperatorios concernientes a la temática. La búsqueda bibliográfica se realizó desde el 13 de septiembre del 2018 hasta el 31 de marzo del 2019 utilizando los términos MESH “Face Transplant” y “Face Transplantation”. Aplicando los criterios de inclusión y exclusión se obtuvieron 43 artículos sobre los cuales se desarrolló la revisión. El trasplante facial es un procedimiento nuevo en el cual hay muchas áreas por explorar, sin embargo, es una alternativa prometedora a los métodos utilizados para la reconstrucción de lesiones faciales complejas, que se optimizará a medida que se extienda su uso.

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Software‐based video analysis of functional outcomes of face transplantation

Abstract: Software-based video analysis provides a valuable assessment tool capable of objective, precise and reproducible analysis of facial movements and functions after FT.

Cited by 13 publications

References 26 publications

Speech Characteristics and Oromyofunctional Outcomes in Two Bimaxillary Face Transplantation Patients in Helsinki

Speech Characteristics and Oromyofunctional Outcomes in Two Bimaxillary Face Transplantation Patients in Helsinki

Enzymatic Debridement for Burn Wound Care: Interrater Reliability and Impact of Experience in Post-intervention Therapy Decision

Trasplante facial generalidades

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