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/archfaci.2010.101

Cited by 48 publications

(13 citation statements)

References 16 publications

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“…Bilateral facial asymmetry is perceived by laypersons if it exceeds a difference of 3 mm at the oral commissure line edges or the brows, or both [19] and most observers correctly detected asymmetry at a difference of 2 mm or more in eyelid closure [20]. Zamanian et al found an inconsistency between asymmetry detection between laypersons and dental professionals, but it was not statistically significant [21].…”

Section: Symmetry Perception and Aesthetic Judgementmentioning

confidence: 99%

Symmetry and Aesthetics in Dentistry

Runte

Dirksen

2021

Symmetry

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Animal bodies in general and faces in particular show mirror symmetry with respect to the median-sagittal plane, with exceptions rarely occurring. Bilateral symmetry to the median sagittal plane of the body also evolved very early. From an evolutionary point of view, it should therefore have fundamental advantages, e.g., more effective locomotion and chewing abilities. On the other hand, the recognition of bilaterally symmetric patterns is an important module in our visual perception. In particular, the recognition of faces with different spatial orientations and their identification is strongly related to the recognition of bilateral symmetry. Maxillofacial surgery and Dentistry affect effective masticatory function and perceived symmetry of the lower third of the face. Both disciplines have the ability to eliminate or mitigate asymmetries with respect to form and function. In our review, we will demonstrate symmetric structures from single teeth to the whole face. We will further describe different approaches to quantify cranial, facial and dental asymmetries by using either landmarks or 3D surface models. Severe facial asymmetries are usually caused by malformations such as hemifacial hyperplasia, injury or other diseases such as Noma or head and neck cancer. This could be an important sociobiological reason for a correlation between asymmetry and perceived disfigurement. The aim of our review is to show how facial symmetry and attractiveness are related and in what way dental and facial structures and the symmetry of their shape and color influence aesthetic perception. We will further demonstrate how modern technology can be used to improve symmetry in facial prostheses and maxillofacial surgery.

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Section: Symmetry Perception and Aesthetic Judgementmentioning

confidence: 99%

Symmetry and Aesthetics in Dentistry

Runte

Dirksen

2021

Symmetry

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“…The casual observers are able to detect as little as 3 mm of facial asymmetry of the oral commissure at rest ( 35 ). In this study, the preoperative mean FAI was 4.87 ± 2.39 mm at rest, and significantly reduced to 1.46 ± 1.30 mm postoperatively ( P < 0.001).…”

Section: Resultsmentioning

confidence: 99%

Multiple Model Evaluation of the Masseteric-to-Facial Nerve Transfer for Reanimation of the Paralyzed Face and Quick Prognostic Prediction

Liu

Zhang

et al. 2022

Front. Surg.

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Facial paralysis is negatively associated with functional, aesthetic, and psychosocial consequences. The masseteric-to-facial nerve transfer (MFNT) has many advantages in facial reanimation. The aim is to evaluate the effectiveness of our MFNT technique and define the potential factors predictive of outcome. The authors conducted a retrospective review of 20 consecutive patients who underwent MFNT using the temporofacial trunk of facial nerve. Videotapes and images were documented and evaluated according to Facial Nerve Grading Scale 2.0 (FNGS2.0) and Sunnybrook Facial Grading System (FGS). The quality-of-life was obtained using the Facial Clinimetric Evaluation (FaCE) Scale. Moreover, Facial Asymmetry Index (FAI), quantitative measurement of the width of palpebral fissure, deviation of the philtrum, and angles or excursions of the oral commissure were applied to explore the effect of the transfer metrically. Multivariable logistic regression models and Cox regression were prepared to predict the effect of MFNT by preoperative clinical features. The patients showed favorable outcomes graded by FNGS2.0, and experienced significantly improved scores in static and dynamic symmetry with slightly elevated scores in synkinesis evaluated by the Sunnybrook FGS. The score of FaCE Scale increased in all domains after reanimation. The quantitative indices indicated the symmetry restoration of the middle and lower face after MFNT. Regression analysis revealed that younger patients with severe facial paralysis are preferable to receive MFNT early for faster and better recovery, especially for traumatic causes. The findings demonstrate that MFNT is an effective technique for facial reanimation, and case screening based on clinical characteristics could be useful for surgical recommendation.

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“…Asymmetry was defined as a greater than 3 mm difference in measurements of the ipsilateral and contralateral sides of the lower face, as the observed threshold of perception of facial asymmetry has been determined to be 3 mm. 25…”

Section: Methodsmentioning

confidence: 99%

Dynamic Reconstruction of Facial Paralysis in Craniofacial Microsomia

Zuo¹,

Heinelt²,

Ho³

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Craniofacial microsomia is associated with maxillomandibular hypoplasia, microtia, soft-tissue deficiency, and variable severity of cranial nerve dysfunction, most often of the facial nerve. This study evaluated the incidence of facial paralysis in patients with craniofacial microsomia and outcomes after free functioning muscle transfer for dynamic smile reconstruction. Methods: A single-center, retrospective, cross-sectional study was performed from 1985 to 2018 to identify pediatric patients with craniofacial microsomia and severe facial nerve dysfunction who underwent dynamic smile reconstruction with free functioning muscle transfer. Preoperative and postoperative facial symmetry and oral commissure excursion during maximal smile were measured using photogrammetric facial analysis software. Results: This study included 186 patients with craniofacial microsomia; 41 patients (21 male patients, 20 female patients) had documented facial nerve dysfunction (22 percent) affecting all branches (51 percent) or the mandibular branch only (24 percent). Patients with severe facial paralysis (n = 8) underwent smile reconstruction with a free functioning muscle transfer neurotized either with a cross-face nerve graft (n = 7) or with the ipsilateral motor nerve to masseter (n =1). All patients achieved volitional muscle contraction with improvement in lip symmetry and oral commissure excursion (median, 8 mm; interquartile range, 3 to 10 mm). The timing of orthognathic surgery and facial paralysis reconstruction was an important consideration in optimizing patient outcomes. Conclusions: The authors’ institution’s incidence of facial nerve dysfunction in children with craniofacial microsomia is 22 percent. Free functioning muscle transfer is a reliable option for smile reconstruction in children with craniofacial microsomia. To optimize outcomes, a novel treatment algorithm is proposed for craniofacial microsomia patients likely to require both orthognathic surgery and facial paralysis reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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

Cited by 48 publications

References 16 publications

Symmetry and Aesthetics in Dentistry

Symmetry and Aesthetics in Dentistry

Multiple Model Evaluation of the Masseteric-to-Facial Nerve Transfer for Reanimation of the Paralyzed Face and Quick Prognostic Prediction

Dynamic Reconstruction of Facial Paralysis in Craniofacial Microsomia

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