Threshold of Visual Perception of Facial Asymmetry in a Facial Paralysis Model

Chu, Eugene A.; Farrag, Tarik Y.; Ishii, Lisa E.; Byrne, Patrick J.

doi:10.1001/archfacial.2010.101

Cited by 62 publications

(61 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Facial lesions have been shown to have an attractiveness penalty ( 13 ) and attract more attention ( 14 ) than other parts of the face. Pictures of individuals with facial paralysis have been ranked as less attractive than individuals without facial paralysis ( 8 ), and typical visual scan-path patterns are redirected toward the side with facial paralysis ( 7 ), a crooked nose ( 15 ) or a facial lesion ( 14 ). Surgical reconstruction and reanimation techniques can potentially address the causes of facial asymmetry, and it is important to know the relationship between side-to-side difference in movement range and/or timing and the resulting perception of movement naturalness.…”

Section: Discussionmentioning

confidence: 99%

“…On the stimulation side, implanted electrodes generate relatively fast movement, while less invasive body surface stimulation may introduce delay that might affect perceived gesture naturalness. Although studies have examined the degree of lateral asymmetry detectable in static images of the face ( 7,8 ), the detection thresholds and perceptual impact of dynamic timing asymmetry has not yet been determined.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Detection and Perceptual Impact of Side-to-Side Facial Movement Asymmetry

Kim

Heller

Hohman

et al. 2013

JAMA Facial Plast Surg

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Detection and Perceptual Impact of Side-to-Side Facial Movement Asymmetry

Kim

Heller

Hohman

et al. 2013

JAMA Facial Plast Surg

View full text Add to dashboard Cite

“…Even minor improvements toward facial symmetry in one facial zone can result in an overall unperceivable facial asymmetry. 64 Interventions accomplishing these goals include the administration of cosmetic fillers to hypertonic nasolabial and melolabial folds or atrophic upper and lower lips. Patients can also modify their cosmetic makeup applications or change their hairstyles to reduce attention toward asymmetric areas.…”

Section: Miscellaneous Facial Balancing Maneuversmentioning

confidence: 99%

Contemporary Solutions for the Treatment of Facial Nerve Paralysis

Garcia

Hadlock²,

Klebuc

et al. 2015

Plastic and Reconstructive Surgery

106

100

View full text Add to dashboard Cite

Facial expression is a complex neuromotor and psychomotor process that is disrupted in patients with facial paralysis breaking the link between emotion and physical expression. Contemporary reconstructive options are being implemented in patients with facial paralysis. While static procedures provide facial symmetry at rest, true 'facial reanimation' requires restoration of facial movement. Contemporary treatment options include neurotization procedures (a new motor nerve is used to restore innervation to a viable muscle), contiguous regional muscle transfer (most commonly temporalis muscle transfer), microsurgical free muscle transfer, and nonsurgical adjuvants used to balance facial symmetry. Each approach has advantages and disadvantages along with ongoing controversies and should be individualized for each patient. Treatments for patients with facial paralysis continue to evolve in order to restore the complex psychomotor process of facial expression.

show abstract

“…4 Moreover, laypeople are able to detect as little as 3 mm of facial asymmetry of the oral commissure at rest. 5 This research speaks to the substantial adversity that patients with facial disfigurement may experience; however, it does not directly address patient-perceived disability. The Facial Clinimetric Evaluation (FaCE) scale is a validated patient-based instrument designed to measure facial impairment and disability, and it permits clinicians to effectively analyze disease-specific quality of life (QOL).…”

mentioning

confidence: 99%

Quality-of-Life Improvement After Free Gracilis Muscle Transfer for Smile Restoration in Patients With Facial Paralysis

Lindsay

Bhama

Hadlock

2014

JAMA Facial Plast Surg

View full text Add to dashboard Cite

IMPORTANCE Facial paralysis can contribute to disfigurement, psychological difficulties, and an inability to convey emotion via facial expression. In patients unable to perform a meaningful smile, free gracilis muscle transfer (FGMT) can often restore smile function. However, little is known about the impact on disease-specific quality of life.OBJECTIVE To determine quantitatively whether FGMT improves quality of life in patients with facial paralysis. DESIGN, SETTING, AND PARTICIPANTS Prospective evaluation of 154 FGMTs performed at a facial nerve center on 148 patients with facial paralysis. The Facial Clinimetric Evaluation (FaCE) survey and Facial Assessment by Computer Evaluation software (FACE-gram) were used to quantify quality-of-life improvement, oral commissure excursion, and symmetry with smile. INTERVENTION Free gracilis muscle transfer. MAIN OUTCOMES AND MEASURES Change in FaCE score, oral commissure excursion, and symmetry with smile. RESULTS There were 127 successful FGMTs on 124 patients and 14 failed procedures on 13 patients. Mean (SD) FaCE score increased significantly after successful FGMT (42.30 [15.9] vs 58.5 [17.60]; paired 2-tailed t test, P < .001). Mean (SD) FACE scores improved significantly in all subgroups (nonflaccid cohort, 37.8 [19.9] vs 52.9 [19.3]; P = .02; flaccid cohort, 43.1 [15.1] vs 59.6 [17.2]; P < .001; trigeminal innervation cohort, 38.9 [14.6] vs 55.2 [18.2]; P < .001; cross-face nerve graft cohort, 47.3 [16.6] vs 61.7 [16.9]; P < .001) except the failure cohort (36.5 [20.8] vs 33.5 [17.9]; Wilcoxon signed-rank test, P = .15). Analysis of 40 patients' photographs revealed a mean (SD) preoperative and postoperative excursion on the affected side of −0.88 (3.79) and 7.68 (3.38), respectively (P < .001); symmetry with smile improved from a mean (SD) of 13.8 (7.46) to 4.88 (3.47) (P < .001). CONCLUSIONS AND RELEVANCEFree gracilis muscle transfer has become a mainstay in the management armamentarium for patients with severe reduction in oral commissure movement after facial nerve insult and recovery. We found a quantitative improvement in quality of life after FGMT in patients who could not recover a meaningful smile after facial nerve insult. Quality-of-life improvement was not statistically different between donor nerve groups or facial paralysis types.LEVEL OF EVIDENCE 3.

show abstract

Threshold of Visual Perception of Facial Asymmetry in a Facial Paralysis Model

Cited by 62 publications

References 18 publications

Detection and Perceptual Impact of Side-to-Side Facial Movement Asymmetry

Detection and Perceptual Impact of Side-to-Side Facial Movement Asymmetry

Contemporary Solutions for the Treatment of Facial Nerve Paralysis

Quality-of-Life Improvement After Free Gracilis Muscle Transfer for Smile Restoration in Patients With Facial Paralysis

Contact Info

Product

Resources

About