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Shamil E, Tan DJY, Grobbelaar A. Outcomes of Free Flap Transfer in Facial Reanimation: A Review. Facial Plast Surg 2024. [PMID: 38336000 DOI: 10.1055/s-0044-1779628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024] Open
Abstract
Free functional muscle transfer is is an option for reanimating the face in chronic facial nerve paralysis. The optimal outcome in these patients is the ability to restore a spontaneous smile in response to emotion. We discuss the role of free functional muscle transfer in facial paralysis treatment, the choices of nerve used in reconstruction surgery, and the application of different types of muscle flaps in facial reanimation. In this paper, we review the relevant and up-to-date academic literature regarding the outcomes of free functional muscle flap transfer in facial paralysis patients.
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Affiliation(s)
- Eamon Shamil
- ENT Surgery Department, The Royal National ENT Hospital, University College London Hospital, London, United Kingdom
| | - Denise Jia Yun Tan
- ENT Surgery Department, Royal Stoke University Hospital, Stoke-on-Trent, Staffordshire, United Kingdom
| | - Adriaan Grobbelaar
- Department of Plastic Surgeon, Great Ormond Street Hospital, London, United Kingdom
- Division of Surgery and Interventional Science, University College of London, London, United Kingdom
- Department of Plastic and Hand Surgery, Inselspital, University Hospital of Bern, Bern, Switzerland
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The Average Facial Expressions: A Range of Motion Analysis for Different Sex and Age Groups. Plast Reconstr Surg Glob Open 2023; 11:e4762. [PMID: 36776597 PMCID: PMC9911205 DOI: 10.1097/gox.0000000000004762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/15/2022] [Indexed: 02/04/2023]
Abstract
Facial expressions are ubiquitous in communication. Therefore, assessment of mimic function is essential in facial surgery, but no reference standards are currently available. This prospective study aims to create reference values of three-dimensional landmark displacement for different sex and age groups. Methods Three-dimensional photographs were taken from healthy subjects in rest, maximum closed smile, and pouting. Displacement for both exercises of perioral landmarks was analyzed with MATLAB as absolute displacement and as the ratio of mouth width. Additionally, displacement in three planes was analyzed for each landmark. Averages were calculated for both genders in four age groups: 4-8, 8-12, 12-16, and >16 years. Results In total, 328 subjects were included. Oral landmarks predominantly moved forward and backward for both exercises. Nasal landmarks predominantly moved vertically. Growing up, oral landmark displacement decreased for smiling, whereas nasal landmark displacement increased. For pouting, oral landmark displacement increased while growing up, whereas nasal landmark displacement decreased. Conclusions The present study creates reference values for movement of perioral structures for different sex and age groups, for two facial expressions. These data are of great value for the assessment of mimic function and give insight into the development of facial animation over time.
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Fuzi J, Meller C, Ch'ng S, Hadlock TM, Dusseldorp J. Voluntary and Spontaneous Smile Quantification in Facial Palsy Patients: Validation of a Novel Mobile Application. Facial Plast Surg Aesthet Med 2022. [DOI: 10.1089/fpsam.2022.0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Jordan Fuzi
- Prince of Wales Hospital, Randwick, Australia
- University of Sydney, Camperdown, Australia
| | | | - Sydney Ch'ng
- University of Sydney, Camperdown, Australia
- Chris O'Brien Lifehouse, Camperdown, Australia
| | | | - Joseph Dusseldorp
- University of Sydney, Camperdown, Australia
- Chris O'Brien Lifehouse, Camperdown, Australia
- Concord Repatriation General Hospital, Concord, Australia
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Nomoto S, Umezawa H, Ogawa R. A Cosmetic Surgical Approach Effectively Reconstructed Facial Nerve Paralysis. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3452. [PMID: 34168937 PMCID: PMC8219252 DOI: 10.1097/gox.0000000000003452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/28/2020] [Indexed: 11/25/2022]
Abstract
In general, facial nerve palsy is treated by reconstructive surgeons, and the role of cosmetic surgeons is largely seen as secondary. The present report describes a case of refractory facial nerve palsy that arose after malignant parotid-tumor resection and high-dose radiotherapy, and that we reconstructed with a combination of cosmetic and reconstructive procedures. The procedures consisted of facelift techniques (lateral SMASectomy, creation of a nasolabial fold with three suture loops anchored at the temporal fascia, and frontal lift), a new wrinkle-removing technique wherein the frontal-muscle function was disrupted, and excision of surplus skin to rejuvenate the face. The outcomes were good, including at 1 year after surgery, and the 71-year-old patient expressed considerable satisfaction. The frontalis muscle resection effectively removed the wrinkles, helped balance the left and right sides, and permitted anti-aging surgery. This procedure has permanent effects, unlike other methods (eg, botulinum-toxin injections) that serve to weaken facial muscle function. It is notable that despite the high-dose radiotherapy the patient had received and the resulting extensive subcutaneous-tissue adhesion, our surgical protocol was relatively easy to perform as well as highly effective. Thus, even static reconstruction can give great hope and satisfaction to patients with facial nerve palsy.
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Affiliation(s)
- Shunichi Nomoto
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan
| | - Hiroki Umezawa
- Research Laboratory for Magnetic Resonance, Nippon Medical School, Tokyo, Japan
| | - Rei Ogawa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan
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Facial Reanimation With Free Latissumus Dorsi Muscle Transfer, a Comparative Study Between Lateral and Supine Approach. J Craniofac Surg 2021; 32:1118-1121. [PMID: 32947333 DOI: 10.1097/scs.0000000000007053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT In this article, the authors present the versatility of the Latissmus dorsi muscle as a donor option in facial reanimation and compare between different approaches in harvesting this muscle.The study included 24 Latissimus Dorsi (LD) functional muscles were transferred for smile reanimation of complete facial palsy. The patients were classified into 2 groups in which the muscle either harvested with supine or lateral (trans-axillary) approach. Muscle harvesting time, total operating times, blood loss, and bulkiness of the flap were analyzed and compared. The hypoglossal nerve was used in 14 cases, the masseteric nerve in 4 cases, and the lower trunk of the facial nerve was used in 6 cases as adonor nerve. No microvascular complications were observed, hematoma occurred in 2 cases only. No donor site complications in any of the cases.The trans-axillary approach provides less operative time, blood loss, and donor site morbidity, while the classic approach is easier and has the advantage of skin paddle in complex cases.
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Evaluating Functional Outcomes in Reanimation Surgery for Chronic Facial Paralysis: A Systematic Review. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3492. [PMID: 33758730 PMCID: PMC7972661 DOI: 10.1097/gox.0000000000003492] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/26/2021] [Indexed: 11/26/2022]
Abstract
Background: Chronic facial paralysis can lead to significant functional and psychosocial impairment. Treatment often involves free muscle flap-based facial reanimation surgery. Although surgical techniques have advanced considerably over the years, consensus has yet to be reached for postoperative outcome evaluation. To facilitate outcome comparison between the various techniques for free muscle-flap-based reanimation, a standardized, widely accepted functional outcomes assessment tool must be adopted. Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we performed a systematic review of the PubMed, Cochrane, and Embase databases to identify the reported functional outcome measurement tools used in the free muscle flap-based reanimation literature. Results: The search yielded 219 articles, 43 of which met our inclusion and exclusion criteria. We noted an increase in publications reporting the utilization of objective measures over time, particularly software-based tools, as well as increased utilization of patient reported outcomes measures. Conclusions: Based on the trends identified in the literature, we suggest standardization of outcome measures following facial reanimation surgery with free muscle-flap using a combination of the Facial Assessment by Computer Evaluation (FACEgram) software and the Facial Clinimetric Evaluation (FaCE) Scale.
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Lower Lip Reanimation: Experience Using the Anterior Belly of Digastric Muscle in 2-stage Procedure. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3461. [PMID: 33747692 PMCID: PMC7963511 DOI: 10.1097/gox.0000000000003461] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/07/2021] [Indexed: 11/26/2022]
Abstract
Supplemental Digital Content is available in the text. Background: Lower lip depression was historically regarded a neglected area of facial paralysis, but, with refinement of techniques, has gained increasing attention. We present the first detailed description and evaluation of a 2-stage technique, using first cross facial nerve graft and then the anterior belly of digastric muscle (ABDM), innervated by the cross facial nerve graft, to restore dynamic and spontaneous lower lip depression. Methods: Retrospective analysis of 2-stage lower lip reanimations between 2010 and 2018 was performed. Demographics, etiology, and operative details were recorded. Videos were graded pre/postoperatively using a 5-point Likert scale by 21 independent observers. Objective changes of symmetry were analyzed using Photogrammetry (Emotrics). Results: Twenty-seven patients were identified (median age 34.9 years, range 6–64). The mean duration between the 2 stages was 15.1 months. Follow-up ranged from 18–72 months. There were minor complications in 4 patients, and 1 case was abandoned due to insufficient length of anterior belly of digastric muscle. Average peer-reviewed scores improved from 2.1 to 3.2 (P < 0.05). Emotrics did not show improvement in static symmetry (P > 0.05). However, during open-lip smiling, lower lip height improved significantly (P < 0.05) whilst dental show improvements approached significance (P < 0.08). Lower lip symmetry was also improved during lower lip depression, as shown by improvements in lower lip height (P < 0.05), smile angle, and dental show (both P < 0.05). Conclusions: These results show the safety and efficacy of 2-stage lower lip reanimation using anterior belly of digastric muscle transposition. This procedure is our choice for longstanding lower lip paralysis and provides coordinated spontaneous lower lip depression, thus enhancing the overall perioral animation and smile.
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Gasteratos K, Azzawi SA, Vlachopoulos N, Lese I, Spyropoulou GA, Grobbelaar AO. Workhorse Free Functional Muscle Transfer Techniques for Smile Reanimation in Children with Congenital Facial Palsy: Case Report and Systematic Review of the Literature. J Plast Reconstr Aesthet Surg 2021; 74:1423-1435. [PMID: 33637466 DOI: 10.1016/j.bjps.2021.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 12/15/2020] [Accepted: 01/23/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Pediatric facial palsy represents a rare multifactorial entity. Facial reanimation restores smiling, thus boosting self-confidence and social integration of the affected children. The purpose of this paper is to present a systematic review of microsurgical workhorse free functional muscle transfer procedures with emphasis on the long-term functional, aesthetic, and psychosocial outcomes. MATERIALS AND METHODS We performed a literature search of the PubMed database from 1995 to 2019 using the following search strategy: "facial paralysis"[Title/Abstract] OR "facial palsy"[Title]. We used as limits: full text, English language, age younger than 18 years, and humans. Two independent reviewers performed the online screening process using Covidence. Forty articles met the inclusion criteria. The protocol was aligned with the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and was registered at the International Prospective Register of Systematic Reviews (PROSPERO, CRD42019150112) of the National Institute for Health Research. RESULTS Free functional muscle transfer procedures include mainly segmental gracilis, latissimus dorsi, and pectoralis minor muscle transfer. Facial reanimation procedures with the use of the cross-face nerve graft (CFNG) or masseteric nerve result in almost symmetric smiles. The transplanted muscle grows harmoniously along with the craniofacial skeleton. Muscle function and aesthetic outcomes improve over time. All children presented improved self-esteem, oral commissure opening, facial animation, and speech. CONCLUSIONS A two-stage CFNG plus an FFMT may restore a spontaneous emotive smile in pediatric facial palsy patients. Superior results of children FFMT compared to adults FFMT are probably attributed to greater brain plasticity.
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Affiliation(s)
- Konstantinos Gasteratos
- Plastic and Reconstructive Surgery Department, Papageorgiou General Hospital, Thessaloniki, Greece.
| | - Saif Al Azzawi
- Microsurgery Fellow, Royal Adelaide Hospital, Port Rd, Adelaide SA 5000, Australia; Melbourne Institute of Plastic Surgery, Malvern, Victoria 3144 Australia; Department of Plastic and Reconstructive Surgery, St Thomas' Hospital, Westminster Bridge Road, London SE7 1EH, United Kingdom
| | - Nikolaos Vlachopoulos
- Graduate of the Aristotle University of Thessaloniki, School of Medicine -Hellenic Military Academy of Combat Support Officers, Thessaloniki, Greece
| | - Ioana Lese
- Department of Plastic and Hand Surgery; Inselspital, Bern University Hospital, Bern, Switzerland; Department of Plastic and Reconstructive Surgery, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom
| | | | - Adriaan O Grobbelaar
- Department of Plastic and Reconstructive Surgery, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom; Department of Plastic and Hand Surgery; Inselspital, Bern University Hospital, Bern, Switzerland; Professor at University College of London, Division of Surgery and Interventional Science, London, United Kingdom
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Liu X, Xia Y, Yu H, Dong J, Jian M, Pham TD. Region Based Parallel Hierarchy Convolutional Neural Network for Automatic Facial Nerve Paralysis Evaluation. IEEE Trans Neural Syst Rehabil Eng 2020; 28:2325-2332. [PMID: 32881689 DOI: 10.1109/tnsre.2020.3021410] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In this article, we propose a parallel hierarchy convolutional neural network (PHCNN) combining a Long Short-Term Memory (LSTM) network structure to quantitatively assess the grading of facial nerve paralysis (FNP) by considering the region-based asymmetric facial features and temporal variation of the image sequences. FNP, such as Bell's palsy, is the most common facial symptom of neuromotor dysfunctions. It causes the weakness of facial muscles for the normal emotional expression and movements. The subjective judgement by clinicians completely depends on individual experience, which may not lead to a uniform evaluation. Existing computer-aided methods mainly rely on some complicated imaging equipment, which is complicated and expensive for facial functional rehabilitation. Compared with the subjective judgment and complex imaging processing, the objective and intelligent measurement can potentially avoid this issue. Considering dynamic variation in both global and regional facial areas, the proposed hierarchical network with LSTM structure can effectively improve the diagnostic accuracy and extract paralysis detail from the low-level shape, contour to sematic level features. By segmenting the facial area into two palsy regions, the proposed method can discriminate FNP from normal face accurately and significantly reduce the effect caused by age wrinkles and unrepresentative organs with shape and position variations on feature learning. Experiment on the YouTube Facial Palsy Database and Extended CohnKanade Database shows that the proposed method is superior to the state of the art deep learning methods.
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Schlosshauer T, Kueenzlen L, Kuehn S, Sader R, Rieger U. Age-dependent outcomes of Gillies and McLaughlin's dynamic muscle support in irreversible facial paralysis with up to 25-year follow-up. J Craniomaxillofac Surg 2020; 48:885-895. [DOI: 10.1016/j.jcms.2020.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 05/19/2020] [Accepted: 06/20/2020] [Indexed: 11/16/2022] Open
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Harkel TCT, Vinayahalingam S, Ingels KJAO, Berge SJ, Maal TJJ, Speksnijder CM. Reliability and Agreement of 3D Anthropometric Measurements in Facial Palsy Patients Using a Low-Cost 4D Imaging System. IEEE Trans Neural Syst Rehabil Eng 2020; 28:1817-1824. [PMID: 32746313 DOI: 10.1109/tnsre.2020.3007532] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The reliability (precision) and agreement (accuracy) of anthropometric measurements based on manually placed 3D landmarks using the RealSense D415 were investigated in this paper. Thirty facial palsy patients, with their face in neutral (resting) position, were recorded simultaneously with the RealSense and a professional 3dMD imaging system. First the RealSense depth accuracy was determined. Subsequently, two observers placed 14 facial landmarks on the 3dMD and RealSense image, assessing the distance between landmark placement. The respective intra- and inter-rater Euclidean distance between the landmark placements was 0.84 mm (±0.58) and 1.00 mm (±0.70) for the 3dMD landmarks and 1.32 mm (±1.27) and 1.62 mm (±1.42) for the RealSense landmarks. From these landmarks 14 anthropometric measurements were derived. The intra- and inter-rater measurements had an overall reliability of 0.95 (0.87 - 0.98) and 0.93 (0.85 - 0.97) for the 3dMD measurements, and 0.83 (0.70 - 0.91) and 0.80 (0.64 - 0.89) for the RealSense measurements, respectively, expressed as the intra-class correlation coefficient. Determined by the Bland-Altman analysis, the agreement between the RealSense measurements and 3dMD measurements was on average -0.90 mm (-4.04 - 2.24) and -0.89 mm (-4.65 - 2.86) for intra- and inter-rater agreement, respectively. Based on the reported reliability and agreement of the RealSense measurements, the RealSense D415 can be considered as a viable option to perform objective 3D anthropomorphic measurements on the face in a neutral position, where a low-cost and portable camera is required.
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Vila PM, Kallogjeri D, Yaeger LH, Chi JJ. Powering the Gracilis for Facial Reanimation: A Systematic Review and Meta-analysis of Outcomes Based on Donor Nerve. JAMA Otolaryngol Head Neck Surg 2020; 146:429-436. [PMID: 32215620 PMCID: PMC7099528 DOI: 10.1001/jamaoto.2020.0065] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/10/2020] [Indexed: 11/14/2022]
Abstract
Importance Free gracilis transfer for dynamic reanimation in chronic facial paralysis is the gold standard, but there remains a need to better understand outcomes with respect to the donor nerve. Objective To characterize outcomes in adults undergoing primary gracilis transfer for facial paralysis stratified by donor nerve used for neurotization. Data Sources Search strategies were used in Ovid MEDLINE (1946-2019), Embase (1947-2019), Scopus (1823-2019), Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov (1997-2019). Study Selection Inclusion and exclusion criteria were designed to capture studies in adults with unilateral chronic facial paralysis undergoing single-paddle free gracilis transfer. All study types were included except case reports. Abstracts and full texts were reviewed in duplicate. Of 130 unique citations, 10 studies including 295 patients were included after applying inclusion and exclusion criteria. Data were analyzed between November 2018 and December 2019. Data Extraction and Synthesis PRISMA guidelines were followed. The Newcastle-Ottawa scale was used to assess study quality, and the Cochrane Risk of Bias tool was used to assess risk of bias. Independent extraction by 2 authors (P.M.V. and J.J.C.) was performed. Data were pooled using a random-effects model. Main Outcomes and Measures Owing to heterogeneity in reporting of facial reanimation outcomes, we first performed a systematic review, and then compiled available outcomes for meta-analysis. Outcomes studied for meta-analysis were oral commissure excursion and facial symmetry. Results Meta-analysis of masseteric nerve (MN) (n = 56) vs cross-facial nerve graft (CFNG) (n = 52) in 3 retrospective studies showed no statistical heterogeneity between these studies (I2 = 0%), and the standardized mean difference (SMD) was greater for MN (0.55; 95% CI, 0.17 to 0.94). Meta-analysis of angles of symmetry in 2 retrospective studies comparing MN (n = 51) to CFNG (n = 47) both at rest (-0.22; 95% CI, -0.63 to 0.18) and with smiling (-0.14; 95% CI, -0.73 to 0.46) were better with MN, though the difference was not statistically significant. Conclusions and Relevance Owing to heterogeneity in reported outcomes from facial reanimation, we were unable to make definitive conclusions regarding the optimal donor nerve. Establishing a reporting standard at peer-reviewed journals to improve results reporting is one method to allow for improved collaboration in the future. Standardizing follow-up times, assessing spontaneity in an objective and reproducible fashion, and use of consistent outcome measures would allow for future meta-analyses and better understanding of options for facial reanimation.
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Affiliation(s)
- Peter M. Vila
- Department of Otolaryngology–Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Dorina Kallogjeri
- Department of Otolaryngology–Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Lauren H. Yaeger
- Bernard Becker Medical Library, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - John J. Chi
- Division of Facial Plastic & Reconstructive Surgery, Department of Otolaryngology–Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
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Krishnan Santha K, Joseph S, Latheef S, Narayanan S, Nair SM, Babu B, Sivadasan A, Shet SM, Pydi RV, Pati A, Samantaray SA. Dynamic smile reanimation in facial nerve palsy. J Korean Assoc Oral Maxillofac Surg 2020; 46:143-149. [PMID: 32364354 PMCID: PMC7222615 DOI: 10.5125/jkaoms.2020.46.2.143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 03/07/2019] [Accepted: 03/18/2019] [Indexed: 11/30/2022] Open
Abstract
Objectives Long-term facial paralysis results in degeneration of the distal nerve segment and atrophy of the supplied muscles. Options for these patients include free muscle transfer, temporalis myoplasty, and botulinum toxin injections for smile reanimation. In this study we aimed to evaluate the subjective and objective outcomes of these procedures. Materials and Methods In our study, we retrospectively analyzed smile symmetry in patients with facial palsy (n=8) who underwent facial reanimation procedures. Results Subjective analysis showed high satisfaction in seven out of eight patients. Objective analysis showed statistically significant improvement postoperatively in both vertical and horizontal smile symmetry at rest and during maximum smile (P<0.001). Conclusion Choosing the ideal procedure for the patients is the most critical aspect for facial reanimation. Though free muscle transfer is considered gold standard procedure, temporalis myoplasty also gives satisfactory results. Residual synkinesis which can lead to disturbing aesthetic deformity can be effectively treated with botulinum toxin.
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Affiliation(s)
| | - Subin Joseph
- Department of Plastic, Reconstructive and Burns Surgery, Baby Memorial Hospital, Kozhikode, India
| | - Sameer Latheef
- Department of Plastic, Reconstructive and Burns Surgery, Baby Memorial Hospital, Kozhikode, India
| | - Saju Narayanan
- Department of Plastic and Reconstructive Surgery, Aster MIMS Hospital, Kozhikode, India
| | | | - Bibilash Babu
- Department of Plastic and Reconstructive Surgery, Aster MIMS Hospital, Kozhikode, India
| | - Anand Sivadasan
- Department of Plastic, Reconstructive and Burns Surgery, Baby Memorial Hospital, Kozhikode, India
| | - Srivatsa Manjunath Shet
- Department of Plastic, Reconstructive and Burns Surgery, Baby Memorial Hospital, Kozhikode, India
| | - Rajesh Vardhan Pydi
- Department of Plastic, Reconstructive and Burns Surgery, Baby Memorial Hospital, Kozhikode, India
| | - Ajit Pati
- Department of Plastic and Reconstructive Surgery, Aster MIMS Hospital, Kozhikode, India
| | - Srikant Aruna Samantaray
- Department of Plastic, Reconstructive and Burns Surgery, Baby Memorial Hospital, Kozhikode, India
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Schlosshauer T, Kueenzlen L, Groetsch T, Kuehn S, Sader R, Rieger U. Long-term outcomes of Gillies and McLaughlin's dynamic muscle support in irreversible facial paralysis: A retrospective single-centre study with 25-year follow-up. J Plast Reconstr Aesthet Surg 2020; 73:1706-1716. [PMID: 32327373 DOI: 10.1016/j.bjps.2020.02.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 01/05/2020] [Accepted: 02/16/2020] [Indexed: 11/29/2022]
Abstract
The aim of this study was to evaluate the long-term outcomes of Gillies and McLaughlin's dynamic muscle support with regard to functional outcomes and assess possible effects of comorbidities on both functional outcomes and reoperation and complication rates. A retrospective single-centre study was conducted in all patients (n = 154) who underwent surgical correction of irreversible facial paralysis from 1994 to 2018. Patients with either Gillies procedure or McLaughlin's dynamic muscle support or a combination of these techniques were included in the analysis. Data on reoperations, comorbidities, complications, functional outcomes and patient satisfaction were analysed. Sixty-nine patients had Gillies and McLaughlin combination, 12 patients had Gillies and 33 patients had McLaughlin procedure alone. Patient satisfaction was generally high (>80%) and highest when McLaughlin procedure alone was performed and in patients without comorbidities. Reoperations were performed in 80 patients (70%; mean 2.2 ± 1.7) and complications affected 16 patients (14%). Smile ability and movement control of the corner of the mouth were achieved in >85% of patients operated, whereas complete eyelid closure and facial symmetry at rest were attained in only 46%‒68% of patients. Patients with no underlying medical conditions were able to smile more often, had motor control of the corner of the mouth, better facial symmetry at rest and fewer complications. Although newer surgical techniques are offered in many centres, this study shows that conventional facial reanimation of irreversible facial paralysis with Gillies or McLaughlin's dynamic muscle support or a combination of both produces yield good results and, therefore, continues to be a viable treatment option for many patients.
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Affiliation(s)
- Torsten Schlosshauer
- Department of Plastic and Aesthetic, Reconstructive and Hand Surgery at AGAPLESION Markus Hospital, Goethe University Frankfurt am Main, Wilhelm-Epstein-Str. 4, 60431 Frankfurt am Main, Germany; Department of Plastic, Aesthetic, Reconstructive and Hand Surgery at AGAPLESION EV. Hospital Central State of Hesse Giessen, Justus Liebig University Giessen, Paul-Zipp-Str. 171, 35398 Giessen, Germany.
| | - Lara Kueenzlen
- Department of Plastic and Aesthetic, Reconstructive and Hand Surgery at AGAPLESION Markus Hospital, Goethe University Frankfurt am Main, Wilhelm-Epstein-Str. 4, 60431 Frankfurt am Main, Germany
| | - Theresa Groetsch
- Department of Plastic and Aesthetic, Reconstructive and Hand Surgery at AGAPLESION Markus Hospital, Goethe University Frankfurt am Main, Wilhelm-Epstein-Str. 4, 60431 Frankfurt am Main, Germany
| | - Shafreena Kuehn
- Department of Plastic and Aesthetic, Reconstructive and Hand Surgery at AGAPLESION Markus Hospital, Goethe University Frankfurt am Main, Wilhelm-Epstein-Str. 4, 60431 Frankfurt am Main, Germany
| | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt, Germany
| | - Ulrich Rieger
- Department of Plastic and Aesthetic, Reconstructive and Hand Surgery at AGAPLESION Markus Hospital, Goethe University Frankfurt am Main, Wilhelm-Epstein-Str. 4, 60431 Frankfurt am Main, Germany
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Butler DP, De la Torre A, Borschel GH, Hadlock TA, Beurskens C, Bogart K, Cárdenas Mejía A, Coombs C, Copeland J, Diels J, González-Otero T, Graham L, Ishii L, Malhotra R, Martinez A, McKinley L, Robinson MW, Suominen S, Takushima A, Vazquez Curiel E, Wachs FL, Grobbelaar AO. An International Collaborative Standardizing Patient-Centered Outcome Measures in Pediatric Facial Palsy. JAMA FACIAL PLAST SU 2020; 21:351-358. [PMID: 31070677 DOI: 10.1001/jamafacial.2019.0224] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Standardization of outcome measurement using a patient-centered approach in pediatric facial palsy may help aid the advancement of clinical care in this population. Objective To develop a standardized outcome measurement set for pediatric patients with facial palsy through an international multidisciplinary group of health care professionals, researchers, and patients and patient representatives. Design, Setting, and Participants A working group of health care experts and patient representatives (n = 21), along with external reviewers, participated in the study. Seven teleconferences were conducted over a 9-month period between December 3, 2016, and September 23, 2017, under the guidance of the International Consortium for Health Outcomes Measurement, each followed with a 2-round Delphi process to develop consensus. This process defined the scope, outcome domains, measurement tools, time points for measurements, and case-mix variables deemed essential to a standardized outcome measurement set. Each teleconference was informed by a comprehensive review of literature and through communication with patient advisory groups. Literature review of PubMed was conducted for research published between January 1, 1981, and November 30, 2016. Main Outcomes and Measures The study aim was to develop the outcomes and measures relevant to children with facial palsy as opposed to studying the effect of a particular intervention. Results The 21 members of the working group included pediatric facial palsy experts from 9 countries. The literature review identified 1628 papers, of which 395 (24.3%) were screened and 83 (5.1%) were included for qualitative evaluation. A standard set of outcome measurements was designed by the working group to allow the recording of outcomes after all forms of surgical and nonsurgical facial palsy treatments among pediatric patients of all ages. Unilateral or bilateral, congenital or acquired, permanent or temporary, and single-territory or multiterritory facial palsy can be evaluated using this standard set. Functional, appearance, psychosocial, and administrative outcomes were selected for inclusion. Clinimetric and psychometric outcome measurement tools (clinician-, patient-, and patient proxy-reported) and time points for measuring patient outcomes were established. Eighty-six independent reviews of the standard set were completed, and 34 (85%) of the 40 patients and patient representatives and 44 (96%) of the 46 health care professionals who participated in the reviews agreed that the standard set would capture the outcomes that matter most to children with facial palsy. Conclusions and Relevance This international collaborative study produced a free standardized set of outcome measures for evaluating the quality of care provided to pediatric patients with facial palsy, allowing benchmarking of clinicians, comparison of treatment pathways, and introduction of value-based reimbursement strategies in the field of pediatric facial palsy. Level of Evidence NA.
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Affiliation(s)
- Daniel P Butler
- Department of Plastic and Reconstructive Surgery, Great Ormond Street Hospital, London, United Kingdom
| | - Alethse De la Torre
- Director of Standardisation and Latin America, International Consortium for Health Outcomes Measurement, Mexico City, Mexico
| | - Gregory H Borschel
- Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Tessa A Hadlock
- Division of Facial Plastic and Reconstructive Surgery, Harvard Medical School, Boston, Massachusetts
| | - Carien Beurskens
- Section of Physical Therapy, Department of Orthopedics, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Alexander Cárdenas Mejía
- Division of Plastic and Reconstructive Surgery, Hospital General Dr Manuel Gea Gonzalez, Postgraduate Division, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
| | - Christopher Coombs
- Department of Plastic and Maxillofacial Surgery, Royal Children's Hospital, Melbourne, Victoria, Australia
| | | | - Jacqueline Diels
- Facial Retraining LLC, Madison, Wisconsin.,Facial Nerve Clinic, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin Hospital and Clinics, Madison
| | | | - Louise Graham
- Patient representative, Brighton, East Sussex, United Kingdom
| | - Lisa Ishii
- Johns Hopkins Hospitals, Baltimore, Maryland
| | - Raman Malhotra
- Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, United Kingdom
| | - Adelaida Martinez
- The Portland Hospital for Women and Children, London, United Kingdom
| | - Lisa McKinley
- Facial Paralysis and Bell's Palsy Foundation, Beverly Hills, California
| | - Mara W Robinson
- Facial Nerve Center, Massachussetts Eye and Ear Infirmary, Boston
| | - Sinikka Suominen
- Department of Plastic Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Akihiko Takushima
- Department of Plastic and Reconstructive Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | | | - Faye L Wachs
- California State Polytechnic University, Los Angeles
| | - Adriaan O Grobbelaar
- University College London, London, United Kingdom.,The Royal Free Hospital, London, United Kingdom.,Great Ormond Street Hospital, London, United Kingdom
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Lou J, Yu H, Wang FY. A Review on Automated Facial Nerve Function Assessment From Visual Face Capture. IEEE Trans Neural Syst Rehabil Eng 2020; 28:488-497. [DOI: 10.1109/tnsre.2019.2961244] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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17
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Berner JE, Kamalathevan P, Kyriazidis I, Nduka C. Facial synkinesis outcome measures: A systematic review of the available grading systems and a Delphi study to identify the steps towards a consensus. J Plast Reconstr Aesthet Surg 2019; 72:946-963. [DOI: 10.1016/j.bjps.2019.03.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/10/2019] [Accepted: 03/10/2019] [Indexed: 11/24/2022]
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18
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Development of the interscutularis model as an outcome measure for facial nerve surgery. Ann Anat 2019; 223:127-135. [DOI: 10.1016/j.aanat.2019.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 03/04/2019] [Accepted: 03/07/2019] [Indexed: 01/23/2023]
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19
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Revenaugh PC, Smith RM, Plitt MA, Ishii L, Boahene K, Byrne PJ. Use of Objective Metrics in Dynamic Facial Reanimation. JAMA FACIAL PLAST SU 2018; 20:501-508. [DOI: 10.1001/jamafacial.2018.0398] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Peter C. Revenaugh
- Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology–Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
| | - Ryan M. Smith
- Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology–Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
| | - Max A. Plitt
- Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology–Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
| | - Lisa Ishii
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Kofi Boahene
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Patrick J. Byrne
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
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Dong A, Zuo KJ, Papadopoulos-Nydam G, Olson JL, Wilkes GH, Rieger J. Functional outcomes assessment following free muscle transfer for dynamic reconstruction of facial paralysis: A literature review. J Craniomaxillofac Surg 2018; 46:875-882. [DOI: 10.1016/j.jcms.2018.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 02/20/2018] [Accepted: 03/13/2018] [Indexed: 10/17/2022] Open
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21
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Alagha M, Ju X, Morley S, Ayoub A. Reproducibility of the dynamics of facial expressions in unilateral facial palsy. Int J Oral Maxillofac Surg 2018; 47:268-275. [DOI: 10.1016/j.ijom.2017.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 07/10/2017] [Accepted: 08/11/2017] [Indexed: 10/18/2022]
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22
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Qualitative and Quantitative Analysis of Smile Excursion in Facial Reanimation: A Systematic Review and Meta-analysis of 1- versus 2-stage Procedures. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2017; 5:e1621. [PMID: 29632792 PMCID: PMC5889470 DOI: 10.1097/gox.0000000000001621] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 11/08/2017] [Indexed: 11/26/2022]
Abstract
Background: Free functional muscle transfer has become a common treatment modality for smile restoration in long-lasting facial paralysis, but the selection of surgical strategy between a 1-stage and a 2-stage procedure has remained a matter of debate. The aim of this study was to compare the quantitative and qualitative outcomes of smile excursion between 1-stage and 2-stage free muscle transfers in the literature. Methods: A comprehensive review of the published literature between 1975 and end of January 2017 was conducted. Results: The abstracts or titles of 2,743 articles were screened. A total of 24 articles met our inclusion criteria of performing a quantitative or qualitative evaluation of a free-functioning muscle transfer for smile restoration. For the purpose of meta-analysis, 7 articles providing quantitative data on a total of 254 patients were included. When comparing muscle excursion between 1-stage and 2-stage procedures, the average range of smile excursion was 11.5 mm versus 6.6 mm, respectively. For the purpose of systematic review, 17 articles were included. The result of the systematic review suggested a tendency toward superior functional results for the 1-stage procedure when comparing the quality of smile. Conclusions: The results of this review must be interpreted with great caution. Quantitative analysis suggests that 1-stage procedures produce better excursion than 2-stage procedures. Qualitative analysis suggests that 1-stage procedures might also produce superior results when based on excursion and symmetry alone, but these comparisons do not include one important variable dictating the quality of a smile—the spontaneity of the smile. The difficulty in comparing published results calls for a consensus classification system for facial palsy.
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23
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Depth accuracy of the RealSense F200: Low-cost 4D facial imaging. Sci Rep 2017; 7:16263. [PMID: 29176666 PMCID: PMC5701257 DOI: 10.1038/s41598-017-16608-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/07/2017] [Indexed: 01/23/2023] Open
Abstract
The RealSense F200 represents a new generation of economically viable 4-dimensional imaging (4D) systems for home use. However, its 3D geometric (depth) accuracy has not been clinically tested. Therefore, this study determined the depth accuracy of the RealSense, in a cohort of patients with a unilateral facial palsy (n = 34), by using the clinically validated 3dMD system as a gold standard. The patients were simultaneously recorded with both systems, capturing six Sunnybrook poses. This study has shown that the RealSense depth accuracy was not affected by a facial palsy (1.48 ± 0.28 mm), compared to a healthy face (1.46 ± 0.26 mm). Furthermore, the Sunnybrook poses did not influence the RealSense depth accuracy (p = 0.76). However, the distance of the patients to the RealSense was shown to affect the accuracy of the system, where the highest depth accuracy of 1.07 mm was measured at a distance of 35 cm. Overall, this study has shown that the RealSense can provide reliable and accurate depth data when recording a range of facial movements. Therefore, when the portability, low-costs, and availability of the RealSense are taken into consideration, the camera is a viable option for 4D close range imaging in telehealth.
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24
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Yoshioka N. Differential Reanimation of the Midface and Lower Face Using the Masseteric and Hypoglossal Nerves for Facial Paralysis. Oper Neurosurg (Hagerstown) 2017; 15:174-178. [DOI: 10.1093/ons/opx217] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 09/15/2017] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Hypoglossal nerve transfer is frequently employed to reanimate the paralyzed facial muscles after irreversible proximal facial nerve injury. However, it can cause significant postoperative synkinesis because it involves the reinnervation of the whole mimetic musculature using a single motor source.
OBJECTIVE
To describe our experience with differential reanimation of the midface and lower face using separate motor sources in patients with short-term facial paralysis after brain surgery.
METHODS
Seven patients underwent combined nerve transfer (the masseteric nerve to the zygomatic branch and the hypoglossal nerve to the cervicofacial division of the facial nerve) and cross-facial nerve grafting with the aim of achieving a spontaneous smile. The median duration of paralysis before surgery was 7 mo and follow-up ranged from 7 to 31 mo (mean: 18 mo). For evaluation, both physical examination and video analysis were performed.
RESULTS
In all patients, reanimation of both the midface and the lower face was successful. A nearly symmetrical resting lip was achieved in all patients, and they were able to voluntarily elevate the corners of their mouths without visible synkinesis and to close their eyes while biting. No patient experienced impairment of masticatory function or tongue atrophy.
CONCLUSION
Differential reanimation of the midface and lower face with the masseteric and hypoglossal nerves is an alternative method that helps to minimize synkinetic mass movement and morbidity at the donor site.
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Affiliation(s)
- Nobutaka Yoshioka
- Department of Craniofacial Surgery and Plastic Surgery, Tominaga Hospital, Osaka, Japan
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25
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Santosa KB, Fattah A, Gavilán J, Hadlock TA, Snyder-Warwick AK. Photographic Standards for Patients With Facial Palsy and Recommendations by Members of the Sir Charles Bell Society. JAMA FACIAL PLAST SU 2017; 19:275-281. [PMID: 28125753 DOI: 10.1001/jamafacial.2016.1883] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance There 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 Participants A 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 Measures The 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. Results In 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 Relevance There 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 recorded. Level of Evidence NA.
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Affiliation(s)
- Katherine B Santosa
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Adel Fattah
- Facial Nerve Programme, Regional Paediatric Burns and Plastic Surgery Service, Alder Hey Children's National Health Service Foundation Trust, Liverpool, England
| | - Javier Gavilán
- Department of Otorhinolaryngology, La Paz University Hospital, Madrid, Spain
| | - Tessa A Hadlock
- Facial Nerve Center, Division of Facial and Plastic and Reconstructive Surgery, Department of Otology and Laryngology, Harvard Medical School and Massachusetts Eye and Ear, Boston
| | - Alison K Snyder-Warwick
- Facial Nerve Institute, Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
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27
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Helwig NE, Sohre NE, Ruprecht MR, Guy SJ, Lyford-Pike S. Dynamic properties of successful smiles. PLoS One 2017; 12:e0179708. [PMID: 28658294 PMCID: PMC5489184 DOI: 10.1371/journal.pone.0179708] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 06/03/2017] [Indexed: 11/29/2022] Open
Abstract
Facial expression of emotion is a foundational aspect of social interaction and nonverbal communication. In this study, we use a computer-animated 3D facial tool to investigate how dynamic properties of a smile are perceived. We created smile animations where we systematically manipulated the smile’s angle, extent, dental show, and dynamic symmetry. Then we asked a diverse sample of 802 participants to rate the smiles in terms of their effectiveness, genuineness, pleasantness, and perceived emotional intent. We define a “successful smile” as one that is rated effective, genuine, and pleasant in the colloquial sense of these words. We found that a successful smile can be expressed via a variety of different spatiotemporal trajectories, involving an intricate balance of mouth angle, smile extent, and dental show combined with dynamic symmetry. These findings have broad applications in a variety of areas, such as facial reanimation surgery, rehabilitation, computer graphics, and psychology.
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Affiliation(s)
- Nathaniel E. Helwig
- Department of Psychology, University of Minnesota, Minneapolis, MN, United States of America
- School of Statistics, University of Minnesota, Minneapolis, MN, United States of America
- * E-mail: (NEH); (SJG); (SL-P)
| | - Nick E. Sohre
- Department of Computer Science & Engineering, University of Minnesota, Minneapolis, MN, United States of America
| | - Mark R. Ruprecht
- School of Statistics, University of Minnesota, Minneapolis, MN, United States of America
| | - Stephen J. Guy
- Department of Computer Science & Engineering, University of Minnesota, Minneapolis, MN, United States of America
- * E-mail: (NEH); (SJG); (SL-P)
| | - Sofía Lyford-Pike
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, MN, United States of America
- * E-mail: (NEH); (SJG); (SL-P)
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Bos R, Reddy SG, Mommaerts MY. Lengthening temporalis myoplasty versus free muscle transfer with the gracilis flap for long-standing facial paralysis: A systematic review of outcomes. J Craniomaxillofac Surg 2016; 44:940-51. [DOI: 10.1016/j.jcms.2016.05.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/10/2016] [Accepted: 05/09/2016] [Indexed: 10/21/2022] Open
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29
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Long-Term Multifunctional Outcome and Risks of Face Vascularized Composite Allotransplantation. J Craniofac Surg 2015; 26:2038-46. [DOI: 10.1097/scs.0000000000002110] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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30
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Aljudaibi N, Risoud M, Duquennoy-Martinot V, Guerreschi P. Re: 'Is there an ideal outcome scoring system for facial reanimation surgery? A review of current methods and suggestions for future publications'. J Plast Reconstr Aesthet Surg 2015; 68:1466-8. [PMID: 26076591 DOI: 10.1016/j.bjps.2015.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 05/18/2015] [Indexed: 11/25/2022]
Affiliation(s)
- N Aljudaibi
- Department of Plastic, Reconstructive and Aesthetic Surgery, Roger Salengro Hospital, University Hospitals of Lille, rue Emile Laine, 59037 Lille, France; Department of Plastic, Reconstructive and Aesthetic Surgery, King Fahad Hospital (MOH), Jeddah, Saudi Arabia.
| | - M Risoud
- Department of Plastic, Reconstructive and Aesthetic Surgery, Roger Salengro Hospital, University Hospitals of Lille, rue Emile Laine, 59037 Lille, France
| | - V Duquennoy-Martinot
- Department of Plastic, Reconstructive and Aesthetic Surgery, Roger Salengro Hospital, University Hospitals of Lille, rue Emile Laine, 59037 Lille, France
| | - P Guerreschi
- Department of Plastic, Reconstructive and Aesthetic Surgery, Roger Salengro Hospital, University Hospitals of Lille, rue Emile Laine, 59037 Lille, France
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