This study introduces digital image correlation (DIC) as a novel technology to objectively quantify pediatric facial symmetry.
Design:
Descriptive cohort study of patients’ facial symmetry as measured by DIC.
Setting:
Academic tertiary care hospital.
Patients:
9 of 12 identified facial palsy and 13 of 26 identified control subjects participated.
Interventions:
DIC was used to quantify facial strain and symmetry as patients made the 5 standard Sunnybrook facial expressions. Each subject was evaluated according to the Sunnybrook scale by 4 evaluators, 3 plastic surgeons, and 1 occupational therapist.
Main Outcome Measure:
The percentage asymmetry values were calculated and compared between the facial palsy and control groups using both DIC and Sunnybrook.
Results:
Using DIC, facial palsy subjects had 32.99% asymmetry compared with 14.84% in controls (P < .01). Using Sunnybrook, facial palsy subjects had 24.11% asymmetry compared to 3.87% in controls (P < .01). The 2 metrics were positively correlated (P < .01). There was significant variability among the Sunnybrook evaluators (P = .02).
Conclusions:
DIC is a novel technique of objectively quantifying facial motion of the animated face. As surgical and medical approaches toward facial palsy expand, it is essential to have a means to compare results and improve patient outcomes.
BaughRFBasuraGJIshiiLEIshiiLESchwartzSRDrumhellerCMBurkholderRDeckardNADawsonCDriscollC. Clinical practice guideline: Bell’s palsy. Otolaryngol Head Neck Surg. 2013;149:S1–S27.
2.
BogartKRTickle-DegnenLAmbadyN. Compensatory expressive behavior for facial paralysis: adaptation to congenital or acquired disability. Rehabil Psychol. 2012;57:43–51.
3.
BradburyETSimonsWSandersR. Psychological and social factors in reconstructive surgery for hemi-facial palsy. J Plast Reconstr Aesthet Surg. 2006;59:272–278.
4.
ChungMSLeeJHKimDYLimYMAhnJHSungYSChoiYJYoonRGBaekJH. The clinical significance of findings obtained on 3D-FLAIR MR imaging in patients with Ramsay-Hunt syndrome. Laryngoscope. 2015;125:950–955.
5.
CoulsonSECroxsonGRAdamsRDO’DwyerNJ. Reliability of the “Sydney,” “Sunnybrook,” and “House Brackmann” facial grading systems to assess voluntary movement and synkinesis after facial nerve paralysis. Otolaryngol Head Neck Surg. 2005;132:543–549.
6.
FattahABorschelGHManktelowRTBezuhlyMZukerRM. Facial palsy and reconstruction. Plast Reconstr Surg. 2012;129:340e–352e.
7.
FattahAYGavilanJHadlockTAMarcusJRMarresHNdukaCSlatteryWHSnyder- WarwickAK. Survey of methods of facial palsy documentation in use by members of the Sir Charles Bell Society. Laryngoscope. 2014;124:2247–2251.
8.
FattahAYGurusingheADGavilanJHadlockJRMarresHNdukaCCSlatteryWHSnyder- WarwickAK. Facial nerve grading instruments: systematic review of the literature and suggestion for uniformity. Plast Reconstr Surg. 2015;135:569–579.
9.
FreyMTzouCHMichaelidouMPonaIHoldAPlachetaE, Kitzinger HB. 3D video analysis of facial movements. Facial Plast Surg Clin North Am. 2011;19:639–646.
10.
HoALScottAMKlassenAFCanoSJPusicALVan LaekenN. Measuring quality of life and patient satisfaction in facial paralysis patients: a systematic review of patient-reported outcome measures. Plast Reconstr Surg. 2012;130:91–99.
11.
HouseJW. Facial nerve grading system. Otolaryngol Head Neck Surg. 1985;93:146–147.
12.
HsuVMWesAMTahiriYCornman-HomonoffJPercecI. Quantified facial soft-tissue strain in animation measured by real-time dynamic 3-dimensional imaging. Plast Reconstr Surg Glob Open. 2014;2:e211.
13.
IacolucciCMBanksCJowettNKozinEDBhamaPKBarbaraMHadlockTA. Development and validation of a spontaneous smile assay. JAMA Facial Plast Surg. 2015;17:191–196.
14.
KanervaMPoussaTPitkarantaA. Sunnybrook and House-Brackmann Facial Grading Systems: intrarater repeatability and interrater agreement. Otolaryngol Head Neck Surg. 2006;135:865–871.
15.
KleissIJHohmanMHSusarlaSMMarresHAHadlockTA. Health-related quality of life in 794 patients with a peripheral facial palsy using the FaCE Scale: a retrospective cohort study. Clin Otolaryngol. 2015;40:651–656.
16.
KleissIJBeurskensCHStalmeierPFIngelsKJMarresHA. Synkinesis assessment in facial palsy: validation of the Dutch Sykinesis Assessment Questionnaire. Acta Neurol Belg. 2016;116:171–178.
17.
MacgregorFC. Facial disfigurement: problems and management of social interaction and implications for mental health. Aesthetic Plast Surg. 1990;14:249–257.
18.
Marron MendesVLasudryJVandermeerenLde FontaineS. Computerised 3D evaluation of the functional eyelid deficit in facial palsy. J Plast Reconstr Aesthet Surg. 2014;67:178–182.
19.
MehtaRPWernickRobinsonMHadlockTA. Validation of the Synkinesis Assessment Questionnaire. Laryngoscope. 2007;117:923–926.
20.
NeelyJGCherianNGDickersonCBNedzelskiJM. Sunnybrook facial grading system: reliability and criteria for grading. Laryngoscope. 2010;120:1038–1045.
21.
ParveseCTinelliCFuriniFAbbamonteMGirominiESalaVDe SilvestriACeciniMDalla ToffolaE. Validation of the Italian version of the Sunnybrook Facial Grading System. Neurol Sci. 2013;34:457–463.
22.
PickworthJSchwartzETysonJ. Optical metrology for finite element measurements. Paper presented at the CAMX Conference and Exhibition; October 2015; Dallas, TX.
23.
ReitzenSDBabbJSLalwaniAK. Significance and reliability of the House-Brackmann grading system for regional facial nerve function. Otolaryngol Head Neck Surg. 2009;140:154–158.
24.
RossBNedzelskiJMMcLeanJA. Efficacy of feedback training in long-standing facial nerve paresis. Laryngoscope. 1991;101:755–750.
25.
RossBGFradetGNedzelskiJM. Development of a sensitive clinical facial grading system. Otolaryngol Head Neck Surg. 1996;114:380–386.
26.
SalgadoMDCurtissSTollefsonTT. Evaluating symmetry and facial motion using 3D videography. Facial Plast Surg Clin North Am. 2010;18:351–356.
27.
SasakiMImamuraYSatoN. Magnetic resonance imaging in congenital facial palsy. Brain Dev. 2008;30:206–210.
28.
SilvaFde MouraMDouradoNXavierJPereiraFMoraisJDiasMLourencoPJudasF. Fracture characterization of human cortical bone under mode I loading. J Biomech Eng. 2015;137:12.
29.
SzetefekPVanleeneMOlssonRCollinsonRPitsillidesAAShefelbineS. Using digital image correlation to determine bone surface strains during loading and after adaptation of the mouse tibia. J Biomech. 2010;43:599–605.
30.
Trilion Quality Systems. World leader in 3D optical strain measurement. http://www.trilion.com. Accessed June 28, 2016.
31.
TysonJSchmidtTGalanulisK. Biomechanics deformation and strain measurements with 3D image correlation photogrammetry. Exp Tech. 2002;26:39–42.
32.
VanSwearingenJMCohnJFTurnbullJMrzaiTJohnsonP. Psychological distress: linking impairment with disability in facial neuromotor disorders. Otolaryngol Head Neck Surg. 1998;118:790–796.
33.
WilsonAJChinBCHsuVMMirzabeigiMNPercecI. Digital image correlation: a novel dynamic three-dimensional imaging technique for precise quantification of the dynamic rhytid and botulinum toxin type A efficacy. Plast Reconstr Surg. 2015;135:869e–876e.
34.
WilsonAJChangBLTaglientiAJChinBCChangCSFolsomNPercecI. A quantitative analysis of onabotulinumtoxin A, abobotulinumtoxin A and incobotulinumtoxin A: a randomized double blind prospective clinical trial of comparative dynamic strain reduction. Plast Reconstr Surg. 2016;137:1424–1433.
