Clinician-Graded Electronic Facial Paralysis Assessment

Banks, Colin; Bhama, Prabhat K; Park, Jong; Hadlock, Charles R.; Hadlock, Tessa A.

doi:10.1097/prs.0000000000001447

Cited by 209 publications

(185 citation statements)

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“…While grading of these suggested views and movements was out of the scope of the present article, other groups have successfully developed and validated an electronic, clinician-graded facial function scale, referred to as the eFACE, 16 which can be applied to these proposed standards. Furthermore, as a result of the findings of the present study, the SCBS urges practitioners to use these minimum photographic and videographic standards in practice.…”

Section: Discussionmentioning

confidence: 99%

Photographic Standards for Patients With Facial Palsy and Recommendations by Members of the Sir Charles Bell Society

Santosa

Fattah

Gavilán

et al. 2017

JAMA Facial Plast Surg

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IMPORTANCEThere is no widely accepted assessment tool or common language used by clinicians caring for patients with facial palsy, making exchange of information challenging. Standardized photography may represent such a language and is imperative for precise exchange of information and comparison of outcomes in this special patient population.OBJECTIVES To review the literature to evaluate the use of facial photography in the management of patients with facial palsy and to examine the use of photography in documenting facial nerve function among members of the Sir Charles Bell Society-a group of medical professionals dedicated to care of patients with facial palsy. DESIGN, SETTING, AND PARTICIPANTSA literature search was performed to review photographic standards in patients with facial palsy. In addition, a cross-sectional survey of members of the Sir Charles Bell Society was conducted to examine use of medical photography in documenting facial nerve function. The literature search and analysis was performed in August and September 2015, and the survey was conducted in August and September 2013. MAIN OUTCOMES AND MEASURESThe literature review searched EMBASE, CINAHL, and MEDLINE databases from inception of each database through September 2015. Additional studies were identified by scanning references from relevant studies. Only English-language articles were eligible for inclusion. Articles that discussed patients with facial palsy and outlined photographic guidelines for this patient population were included in the study. The survey was disseminated to the Sir Charles Bell Society members in electronic form. It consisted of 10 questions related to facial grading scales, patient-reported outcome measures, other psychological assessment tools, and photographic and videographic recordings. RESULTSIn total, 393 articles were identified in the literature search, 7 of which fit the inclusion criteria. Six of the 7 articles discussed or proposed views specific to patients with facial palsy. However, none of the articles specifically focused on photographic standards for the population with facial palsy. Eighty-three of 151 members (55%) of the Sir Charles Bell Society responded to the survey. All survey respondents used photographic documentation, but there was variability in which facial expressions were used. Eighty-two percent (68 of 83) used some form of videography. From these data, we propose a set of minimum photographic standards for patients with facial palsy, including the following 10 static views: at rest or repose, small closed-mouth smile, large smile showing teeth, elevation of eyebrows, closure of eyes gently, closure of eyes tightly, puckering of lips, showing bottom teeth, snarling or wrinkling of the nose, and nasal base view. CONCLUSIONS AND RELEVANCEThere is no consensus on photographic standardization to report outcomes for patients with facial palsy. Minimum photographic standards for facial paralysis publications are proposed. Videography of the dynamic movements of these views should also be ...

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Section: Discussionmentioning

confidence: 99%

Photographic Standards for Patients With Facial Palsy and Recommendations by Members of the Sir Charles Bell Society

Santosa

Fattah

Gavilán

et al. 2017

JAMA Facial Plast Surg

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“…Prior to beginning this study, approval was obtained from the Massachusetts Eye and Ear Infirmary Institutional Review Board. Since eFACE was implemented in our Center (February 2014), patients had their degree of facial palsy evaluated using it. In our retrospective study, every patient who underwent assessment between February 2014 and October 2017 and who had both a QoL questionnaire and an eFACE score from the same time point were included.…”

Section: Methodsmentioning

confidence: 99%

“…The eFACE, a reliable and valid method of documenting facial function, and the Facial Clinimetric Evaluation (FaCE) scale, a widely adopted patient‐reported outcome measure of facial palsy‐related QoL, were used. The FaCE total score was used as our outcome measure because we set out to study the effect of FP severity on overall FP‐related QoL.…”

Section: Methodsmentioning

confidence: 99%

Facial Palsy‐Specific Quality of Life in 920 Patients: Correlation With Clinician‐Graded Severity and Predicting Factors

et al. 2018

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“…Functioning free muscle transplantation (FFMT) is now the standard of care for reconstructing a functional and aesthetic smile. The merits and drawbacks of the various possible donor muscles (Alagoz, Alagoz, & Comert, ; Chuang, ; Ferguson et al, ; Harrison & Grobbelaar, ; Tzou & Aszmann, ), neurotizers (Chuang, Lu, & Anesti, ; Manktelow, Tomat, Zuker, & Chang, ; O'Brien, Franklin, & Morrison, ), and outcomes assessment tools (Banks, Bhama, Park, Hadlock, & Hadlock, ; Bhama et al, ; Chuang et al, ; Hontanilla & Marre, ; Lindsay, Bhama, & Hadlock, ; Ross, Fradet, & Nedzelski, ; Tomat & Manktelow, ) are the current topics of debate. There is a growing trend toward the use of FFMT in reconstruction for older patients, and thus the effect of patient age on outcome is becoming increasingly relevant (Hembd et al, ; Manktelow et al, ; Terzis & Olivares, ).…”

Section: Introductionmentioning

confidence: 99%

Impact of increasing age on functioning free muscle transplantation for facial palsy reconstruction

Fang

Lin

et al. 2019

Microsurgery

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Background Management of facial paralysis in older patients is controversial. The purpose of this study is to evaluate the impact of increasing age on functioning free muscle transplantation (FFMT). Patients and Methods Twenty‐nine facial paralysis patients over 50 years old received FFMT. A separate group of patients aged 41–50 years old were included as control. Outcome assessments included use of the SMILE evaluation system for excursion, a cortical adaptation scoring system for brain plasticity, and a subjective satisfaction assessment score. Meta‐analysis of literature over the past 50 years was also performed to examine the impact of older age. Results The mean change in excursion movement was 13.39 ± 5.49 mm. Weakest excursion was found in the oldest age group (11.74 ± 4.84 mm, p = .097), in concordance with the meta‐analysis. There was significant difference between the three different neurotizers (p = .036). Excursion and satisfaction score were significantly worse in the older cohort with the cross face‐nerve graft FFMT. Conclusions FFMT is a viable option in the elderly patient group but performs weaker in excursion. The choice of neurotizer is dependent on the patient's goals and the suitable age at which the benefits outweigh the risks.

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Clinician-Graded Electronic Facial Paralysis Assessment

Abstract: The eFACE is a reliable, reproducible, and straightforward digital clinical measure with which to assess facial function and disfigurement in patients with facial paralysis.

Cited by 209 publications

References 4 publications

Photographic Standards for Patients With Facial Palsy and Recommendations by Members of the Sir Charles Bell Society

Photographic Standards for Patients With Facial Palsy and Recommendations by Members of the Sir Charles Bell Society

Facial Palsy‐Specific Quality of Life in 920 Patients: Correlation With Clinician‐Graded Severity and Predicting Factors

Impact of increasing age on functioning free muscle transplantation for facial palsy reconstruction

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