Web-based sensitivity training for interacting with facial paralysis.
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ABSTRACT:
SUBMITTER: Zhang N
PROVIDER: S-EPMC8782395 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Quantitative grading and classification of the severity of facial paralysis (FP) are important for selecting the treatment plan and detecting subtle improvement that cannot be detected clinically. To date, none of the available FP grading systems have gained widespread clinical acceptance. The work presented here describes the development and testing of a system for FP grading and assessment which is part of a comprehensive evaluation system for FP. The system is based on the Kinect v2 hardware and the accompanying software SDK 2.0 in extracting the real time facial landmarks and facial animation units (FAUs). The aim of this paper is to describe the development and testing of the FP assessment phase (first phase) of a larger comprehensive evaluation system of FP. The system includes two phases; FP assessment and FP classification. A dataset of 375 records from 13 unilateral FP patients was compiled for this study. The FP assessment includes three separate modules. One module is the symmetry assessment of both facial sides at rest and while performing five voluntary facial movements. Another module is responsible for recognizing the facial movements. The last module assesses the performance of each facial movement for both sides of the face depending on the involved FAUs. The study validates that the FAUs captured using the Kinect sensor can be processed and used to develop an effective tool for the automatic evaluation of FP. The developed FP grading system provides a detailed quantitative report and has significant advantages over the existing grading scales. It is fast, easy to use, user-independent, low cost, quantitative, and automated and hence it is suitable to be used as a clinical tool.
| S-EPMC9750034 | biostudies-literature
Project description:Facial nerve palsy is a condition with several implications, particularly when occurring in childhood. It represents a serious clinical problem as it causes significant concerns in doctors because of its etiology, its treatment options and its outcome, as well as in little patients and their parents, because of functional and aesthetic outcomes. There are several described causes of facial nerve paralysis in children, as it can be congenital (due to delivery traumas and genetic or malformative diseases) or acquired (due to infective, inflammatory, neoplastic, traumatic or iatrogenic causes). Nonetheless, in approximately 40%-75% of the cases, the cause of unilateral facial paralysis still remains idiopathic. A careful diagnostic workout and differential diagnosis are particularly recommended in case of pediatric facial nerve palsy, in order to establish the most appropriate treatment, as the therapeutic approach differs in relation to the etiology.
| S-EPMC4677084 | biostudies-literature
Project description:BackgroundFacial paralysis is one of the conditions that affect functionally, emotionally and aesthetically to patients greatly. Multiple techniques have been described for its treatment, and we consider that Labbé's technique is the one that most surprises with its results.Materials and methodsIn the Specialty Hospital "Dr. Bernardo Sepúlveda" National Medical Center Century XXI (CMN SXXI), Mexican Institute of Social Security (IMSS), three cases are presented: patients with facial paralysis due to trauma, surgical damage on the VII cranial nerve and conditions due to otological and idiopathic infections. Four modifications to the original Labbé technique are proposed to execute it more easily: trans-zygomatic oblique osteotomy, to reach directly the coronoid process; osteotomy of the descending coronoid; radiated suture fixation at 180° for temporary muscle replacement with positional replacement of the sutures trans-operatively; and the next day of the intervention with the patient awake, fixation of the orbicularis muscle of the lips, to the temporal tendon previously referenced. The modifications and results obtained are shown.ResultsThe modifications offer a better surgical technique and very favorable results.ConclusionsThe modification to Labbé technique gives excellent results in the treatment of permanent facial paralysis, improving facial symmetry, salivary incontinence, facial tone, improving speech, giving the patient movement on the affected side and the ability to smile again.
| S-EPMC8934899 | biostudies-literature
Project description:ObjectiveFunctional deficits induced by nerve injuries can be restored by achieving effective reinnervation of the denervated targets and functional reorganization of the central nervous system after nerve reconstruction. In this study, we investigated the effect and extent of cortical functional reorganization related to the ability of transferred hypoglossal neurons to restore facial function in facial paralysis patients after a surgical bridge of neurorrhaphy ectopically between the ipsilateral hypoglossal nerve and injured facial nerve.MethodsWe treated 23 patients (35.4 ± 10.3 years, 10 males) and followed them up for 2.9 ± 0.61 years. We used motor-task-related functional magnetic resonance imaging to map activation change at multiple time points before and after neurorrhaphy; 20 normal subjects were included as control.ResultsAll patients regained facial function to some extent after neurorrhaphy. Enhanced activation in motor-related cortices gradually returned to normal levels and was positively correlated with regained facial function. The related cortical functional areas included the left middle temporal gyrus, left inferior frontal gyrus, insula, bilateral motor cortex and the supplementary motor area extending to the paracingulate involved in intensive eye closing, as well as the left superior temporal gyrus, right putamen and the bilateral motor cortex involved in lip pursing. Intriguingly, significant correlations were found between the pre-surgery activation while intensive eye closing in bilateral motor cortex and recovery of facial nerve function induced by the neurorrhaphy treatment.ConclusionThis is the first study mapping activation change in motor cortices at multiple time points before and after repair of the facial nerve. The cortex functional reorganization found may suggest potential treatment targets in the central nervous system for adjuvant therapies such as repetitive transcranial magnetic stimulation to further improve functional recovery.
| S-EPMC8405913 | biostudies-literature
Project description:The global burden of snakebites is growing, particularly its nonfatal sequelae. Therefore, the World Health Organization reinstated snakebites to its list of Neglected Tropical Diseases. We describe the case of a 4.5-year-old boy who was bitten by a spitting cobra, resulting in considerable local swelling accompanied by a right-sided facial paralysis due to neurotoxicity by cobra venom. Presently, surgical methods to recover facial paralysis include nerve repair, nerve grafting, nerve transfers, static slings, muscle transfers, and functional muscle transplantations. However, mime therapy consisting of neuromuscular retraining resulted in a good functional result with a moderate contour deficiency of the right cheek and a subtle paresis of the zygomatic muscles at 1 year and 9 months follow-up. The natural history of facial paralysis in our case shows that this condition can be transient and may resolve with mime therapy as a conservative measure.
| S-EPMC8220298 | biostudies-literature
Project description:Exposure and response prevention (ERP) is a first-line behavior therapy for obsessive-compulsive disorder and Tourette syndrome (TS). However, ERP for tic disorders requires intentional tic suppression, which for some patients is difficult even for brief periods. Additionally, practical access to behavior therapy is difficult for many patients, especially those in rural areas. The authors present a simple, working web platform (TicTrainer) that implements a strategy called reward-enhanced exposure and response prevention (RE-ERP). This strategy sacrifices most expert therapist components of ERP, focusing only on increasing the duration of time for which the user can suppress tics through automated differential reinforcement of tic-free periods (DRO). RE-ERP requires an external tic monitor, such as a parent, during training sessions. The user sees increasing digital rewards for longer and longer periods of successful tic suppression, similar to a video game score. TicTrainer is designed with security in mind, storing no personally identifiable health information, and has features to facilitate research, including optional masked comparison of tics during DRO vs. noncontingent reward conditions. A working instance of TicTrainer is available from https://tictrainer.com/.
| S-EPMC6117856 | biostudies-literature
Project description:ImportanceProblems with speech in patients with facial paralysis are frequently noted by both clinicians and the patients themselves, but limited research exists describing how facial paralysis affects verbal communication.ObjectiveTo assess the influence of facial paralysis on communicative participation.Design, setting, and participantsA nationwide online survey of 160 adults with unilateral facial paralysis was conducted from March 1 to June 1, 2017. To assess communicative participation, respondents completed the Communicative Participation Item Bank (CPIB) Short Form questionnaire and the Facial Clinimetric Evaluation (FaCE) Scale.Main outcomes and measuresThe CPIB Short Form and the correlation between the CPIB Short Form and FaCE Scale. In the CPIB, the level of interference in communication is rated on a 4-point Likert scale (where not at all = 3, a little = 2, quite a bit = 1, and very much = 0). Total scores for the 10 items range from 0 (worst) to 30 (best). The FaCE Scale is a 15-item instrument that produces an overall score ranging from 0 (worst) to 100 (best), with higher scores representing better function and higher quality of life.ResultsOf the 160 respondents, 145 (90.6%) were women and 15 were men (mean [SD] age, 45.1 [12.6] years). Most respondents reported having facial paralysis for more than 3 years. Causes of facial paralysis included Bell palsy (86 [53.8%]), tumor (41 [25.6%]), and other causes (33 [20.6%]), including infection, trauma, congenital defects, and surgical complications. The mean (SD) score on the CPIB Short Form was 0.16 (0.88) logits (range, -2.58 to 2.10 logits). The mean (SD) score of the FaCE Scale was 40.92 (16.05) (range, 0-83.3). Significant correlations were observed between the CPIB Short Form and overall FaCE Scale scores, as well as the Social Function, Oral Function, Facial Comfort, and Eye Comfort subdomains of the FaCE Scale, but not with the Facial Movement subdomain.Conclusions and relevancePatients with facial paralysis in this study sample reported restrictions in communicative participation that were comparable with restrictions experienced by patients with other known communicative disorders, such as laryngectomy and head and neck cancer. We believe that communicative participation represents a unique domain of dysfunction and can help quantify the outcome of facial paralysis and provide an additional frame of reference when assessing treatment outcomes.
| S-EPMC6142995 | biostudies-literature
Project description:ImportanceFacial paralysis (FP) after surgery has substantial functional, emotional, and financial consequences. Most iatrogenic FP is managed by watchful waiting, with the expectation of facial function recovery. A potential treatment is physical therapy (PT).ObjectiveTo investigate whether noninvasive PT compared with no PT or other intervention improves facial nerve outcomes in adults with iatrogenic FP.Evidence reviewPatients with noniatrogenic FP, facial reanimation surgery, and invasive adjunctive treatments (acupuncture or botulinum toxin injection) were excluded. A systematic review was conducted for records discussing iatrogenic FP and PT; a search for these records was performed using Ovid MEDLINE (1946-2019), Embase (1947-2019), Scopus (1823-2019), Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, World Health Organization International Clinical Trials Registry Platform (2004-2019), and ClinicalTrials.gov (1997-2019). The references of all the included articles were also assessed for eligible studies. All human participant, English-language study designs with at least 2 cases were included. Quality assessment was performed using the Methodological Index for Non-randomized Studies (MINORS) and the revised Cochrane Risk of Bias 2 (RoB 2) tool for randomized controlled trials. All search strategies were completed on May 16, 2019, and again on October 1, 2019.FindingsFifteen studies (7 of which were retrospective cohort studies) and 313 patients with iatrogenic FP were included in the systematic review. Most iatrogenic FP (166 patients [53%]) was associated with parotidectomy; traditional PT (ie, facial massage) was the most common intervention (196 patients [63%]). The use of various facial grading systems and inconsistent reporting of outcomes prevented direct comparison of PT types.Conclusions and relevanceBecause of heterogeneity in reported outcomes of facial nerve recovery, definitive conclusions were unable to be made regarding the association between PT and outcomes of iatrogenic FP. Physical therapy probably has benefit and is associated with no harm in patients with iatrogenic FP.
| S-EPMC8048107 | biostudies-literature
Project description:Current recommendations envisage early surgical exploration for complete facial nerve paralysis associated with temporal bone fracture and unfavorable electrophysiologic features (response to electroneuronography, <5%). However, the evidence base for such a practice is weak, with the potential for spontaneous improvement being unknown, and the expected results from alternative nonsurgical treatment also undefined.To document the results of nonsurgical treatment for posttraumatic complete facial paralysis with undisplaced temporal bone fracture and unfavorable electrophysiologic features.Prospective cohort study recruiting from April 2010 to April 2013 at a tertiary care university hospital. Follow-up continued until 9 months or until complete recovery if earlier. Study group included 28 patients with head injury-associated complete unilateral facial nerve paralysis with unfavorable results of electroneuronography (<5% response) with or without undisplaced temporal bone fracture. Undisplaced temporal bone fractures were documented in 26 patients (24 longitudinal fractures and 2 transverse fractures).Patients received prednisolone, 1 mg/kg, for 3 weeks combined with clinical monitoring every 2 weeks and electromyography monitoring every 4 weeks. As per study protocol, surgical exploration was limited to patients demonstrating motor end plate degeneration on results of electromyography, or having no improvement until 18 weeks.Facial nerve function was evaluated by the House-Brackmann grading system; Forehead, Eye, Mouth, and Associated defect grading system; and the modified Adour system. Observations were completed at 40 weeks.Among the 28 patients in the study (3 women and 25 men; mean [SD] age, 32.2 [8.7] years), facial nerve recovery with conservative treatment alone was noted in all patients. No recovery was seen in any patient at the initial 4-week review. The first signs of clinical recovery were noted in 4 patients by 8 weeks, in 27 patients by 12 weeks, and in all patients by 20 weeks. No patient required surgical exploration. At 40 weeks, 27 patients recovered to House-Brackmann grade I/II and 1 patient to grade III. All 24 patients with longitudinal fractures had grade I/II recovery.For undisplaced temporal bone fractures, nonsurgical treatment leads to near-universal recovery to House-Brackmann grade I/II and is superior to reported surgical results. Recovery is delayed and usually first manifests at 8 to 12 weeks after the fracture. In the current era of high-resolution computed tomography, surgical exploration should not be first-line treatment for undisplaced longitudingal temporal bone fractures associated with complete facial nerve paralysis and unfavorable electrophysiologic features.
| S-EPMC5876901 | biostudies-other
Project description:BackgroundRecognizing facial expressions is an important social skill. In some psychological disorders such as schizophrenia, loss of this skill may complicate the patient's daily life. Prior research has shown that information technology may help to develop facial expression recognition skills through educational software and games.ObjectivesTo examine if a computer game designed for teaching facial expressions would improve facial expression recognition skills of patients with schizophrenia.MethodsWe developed a website composed of eight serious games. Thirty-two patients were given a pre-test composed of 21 facial expression photographs. Eighteen patients were in the study group while 14 were in the control group. Patients in the study group were asked to play the games on the website. After a period of one month, we performed a post-test for all patients.ResultsThe median score of the correct answers was 17.5 in the control group whereas it was 16.5 in the study group (of 21) in pretest. The median post-test score was 18 in the control group (p=0.052) whereas it was 20 in the study group (p<0.001).ConclusionsComputer games may be used for the purpose of educating people who have difficulty in recognizing facial expressions.
| S-EPMC6220685 | biostudies-literature