A Contemporary Approach to Facial Reanimation

Jowett, Nate; Hadlock, Tessa A.

doi:10.1001/jamafacial.2015.0399

Cited by 68 publications

(45 citation statements)

References 44 publications

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“…Facial nerve function and regeneration outcomes following insult vary widely, depending on myriad clinical factors . Clinical outcomes research in facial palsy is often limited by lack of objective and quantitative evaluation of facial function .…”

Section: Introductionmentioning

confidence: 99%

The spectrum of facial palsy: The MEEI facial palsy photo and video standard set

et al. 2019

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Objectives: Facial palsy causes variable facial disfigurement ranging from subtle asymmetry to crippling deformity. There is no existing standard database to serve as a resource for facial palsy education and research. We present a standardized set of facial photographs and videos representing the entire spectrum of flaccid and nonflaccid (aberrantly regenerated or synkinetic) facial palsy. To demonstrate the utility of the dataset, we describe the relationship between level of facial function and perceived emotion expression as determined by an automated emotion detection, machine learning-based algorithm.Methods: Photographs and videos of patients with both flaccid and nonflaccid facial palsy were prospectively gathered. The degree of facial palsy was quantified using eFACE, House-Brackmann, and Sunnybrook scales. Perceived emotion during a standard video of facial movements was determined using an automated, machine learning algorithm.Results: Sixty participants were enrolled and categorized by eFACE score across the range of facial function. Patients with complete flaccid facial palsy (eFACE <60) had a significant loss of perceived joy compared to the nonflaccid and normal groups. Additionally, patients with only moderate flaccid and nonflaccid facial palsy had a significant increase in perceived negative emotion (contempt) when compared to the normal group.Conclusion:We provide this open-source database to assist in comparing current and future scales of facial function as well as facilitate comprehensive investigation of the entire spectrum of facial palsy. The automated machine learning-based algorithm detected negative emotions at moderate levels of facial palsy and suggested a threshold severity of flaccid facial palsy beyond which joy was not perceived.

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Section: Introductionmentioning

confidence: 99%

The spectrum of facial palsy: The MEEI facial palsy photo and video standard set

et al. 2019

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Section: Introductionmentioning

confidence: 99%

“…Management of advanced parotid malignancy may necessitate facial nerve resection, with primary reconstruction utilizing interposition grafts, nerve transfers, and/or facial slings. 1,2 In cases in which primary interventions fail to restore a meaningful smile, secondary reanimation techniques should be considered. Although the efficacy of free muscle transfer for smile reanimation has been widely reported, [3][4][5][6][7][8][9] its utilization after multimodal therapy for advanced parotid malignancy has heretofore not been well characterized.…”

Section: Introductionmentioning

confidence: 99%

Free gracilis muscle transfer for smile reanimation after treatment for advanced parotid malignancy

et al. 2017

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“…acial movement disorders are associated with functional, aesthetic, and psychological consequences. [1][2][3][4][5] Facial nerve physicians lack consensus regarding tools to assess facial function. In the modern era, thorough assessment of patients with facial paralysis must include physiciangraded scales, patient-reported outcome measures, and quantitative assessments of facial function.…”

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confidence: 99%

Emerging vs Time-Tested Methods of Facial Grading Among Patients With Facial Paralysis

Gaudin

Robinson

Banks

et al. 2016

JAMA Facial Plast Surg

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IMPORTANCE Most rehabilitation specialists and many facial reanimation surgeons use the Sunnybrook Facial Grading System (FGS) to measure and detect changes in facial function. The eFACE, an electronic and digitally graded facial measurement scale, was recently created to provide similar information to the Sunnybrook FGS, but with scaling uniformity across all categories of facial function, graphical outputs, and easy-to-use visual analog scales. OBJECTIVES To establish the correlation between the scores on the eFACE and the Sunnybrook FGS among patients with facial paralysis and to compare the reliability of the 2 scales. DESIGN, SETTING, AND PARTICIPANTS A retrospective review of medical records identified 109 patients who were evaluated at a facial nerve center by physical therapists using the eFACE and the Sunnybrook FGS on the same day, between November 1, 2014, and May 31, 2015. The level of facial function predicted using the 2 scales was compared to study correlation between the scales. Data analysis was conducted from June 1 to September 1, 2015. MAIN OUTCOMES AND MEASURES Correlation between the Sunnybrook FGS and the eFACE grading scale. METHODS Two independent physical therapists evaluated patients using both the eFACE and the Sunnybrook FGS. Scores were compared and the Spearman rank correlation coefficient was calculated between the total scores and each of the 3 subscores, including static, dynamic, and synkinesis scores. The total Sunnybrook FGS synkinesis score (worst score, 15; perfect score, 0) and static score (worst score, 20; perfect score, 0) were normalized to a 100-point scale with the eFACE (perfect score, 100; worst score, 1). RESULTS eFACE scores ranged from 48 to 100, and Sunnybrook FGS scores ranged from 0 to 100. Among 109 patients, there was a moderately strong correlation between eFACE and Sunnybrook FGS scores in both total and subcategory scores. The Spearman rank correlation coefficient of the total eFACE and Sunnybrook FGS was 0.75 (r < 0.0001). For the static scores, the correlation coefficient was-0.71 (r < 0.0001). The correlation coefficients for the dynamic and synkinesis scores were 0.77 (r < 0.0001) and-0.78 (r < 0.0001), respectively. CONCLUSIONS AND RELEVANCE There is moderately good agreement between the Sunnybrook FGS and the eFACE. Given the ease of using the eFACE on mobile devices, as well as its additional functionality, it may represent a reasonable facial grading option across disciplines in the future. LEVEL OF EVIDENCE NA.

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A Contemporary Approach to Facial Reanimation

Cited by 68 publications

References 44 publications

The spectrum of facial palsy: The MEEI facial palsy photo and video standard set

The spectrum of facial palsy: The MEEI facial palsy photo and video standard set

Free gracilis muscle transfer for smile reanimation after treatment for advanced parotid malignancy

Emerging vs Time-Tested Methods of Facial Grading Among Patients With Facial Paralysis

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