Automatic Objective Severity Grading of Peripheral Facial Palsy Using 3D Radial Curves Extracted from Point Clouds
Tim Büchner and Sven Sickert and Gerd F. Volk and Orlando Guntinas-Lichius and Joachim Denzler.
Challenges of Trustable AI and Added-Value on Health.
Pages 179-183.
2022.
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Peripheral facial palsy is an illness in which a one-sided ipsilateral paralysis of the facial muscles occurs due to nerve damage. Medical experts utilize visual severity grading methods to estimate this damage. Our algorithm-based method provides an objective grading using 3D point clouds. We extract from static 3D recordings facial radial curves to measure volumetric differences between both sides of the face. We analyze five patients with chronic complete peripheral facial palsy to evaluate our method by comparing changes over several recording sessions. We show that our proposed method allows an objective assessment of facial palsy.
Automatic and Objective Facial Palsy Grading Index Prediction using Deep Feature Regression
Anish Raj and Oliver Mothes and Sven Sickert and Gerd F. Volk and Orlando Guntinas-Lichius and Joachim Denzler.
Annual Conference on Medical Image Understanding and Analysis (MIUA).
Pages 253-266.
2020.
[bibtex]
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One of the main reasons for a half-sided facial paralysis is caused by a dysfunction of the facial nerve. Physicians have to assess such a unilateral facial palsy with the help of standardized grading scales to evaluate the treatment. However, such assessments are usually very subjective and they are prone to variance and inconsistency between physicians regarding their experience. We propose an automatic non-biased method using deep features combined with a linear regression method for facial palsy grading index prediction. With an extension of the free software tool Auto-eFace we annotated images of facial palsy patients and healthy subjects according to a common facial palsy grading scale. In our experiments, we obtained an average grading error of 11%
Functional outcome and quality of life after hypoglossal-facial jump nerve suture
Gerd F. Volk and Maren Geitner and Katharina Geißler and Jovanna Thielker and Ashraf Raslan and Oliver Mothes and Christian Dobel and Orlando Guntinas-Lichius.
Frontiers Surgery - Otorhinolaryngology - Head and Neck Surgery.
2020.
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Background: To evaluate the face-specific quality of life after hypoglossal-facial jump nervesuture for patients with long-term facial paralysis. Methods: A single-center retrospective cohort study was performed. 41 adults (46% women; median age: 55 years) received a hypoglossal-facial jump nerve suture. Sunnybrook and eFACE grading was performed before surgery and at a median time of 42 months after surgery. The Facial Clinimetric Evaluation (FaCE) survey and the Facial Disability Index (FDI) were used to quantify face-specific quality of life after surgery. Results: Hypoglossal-facial jump nerve suture was successful in all cases without tongue dysfunction. After surgery, the median FaCE Total score was 60 and the median FDI Total score was 76.3. Most Sunnybrook and eFACE grading subscores improved significantly after In surgery. Younger age was the only consistent independent predictor for better FaCE outcome. Additional upper eyelid weight loading further improved the FaCE Eye comfort subscore. Sunnybrook grading showed a better correlation to FaCE assessment than the eFACE. Neither Sunnybrook nor eFACE grading correlated to the FDI assessment. Conclusion: The hypoglossal-facial jump nerve suture is a good option for nerve transfer to reanimate the facial muscles to improve facial motor function and face-specific quality of life.
Long-term home-based Surface Electrostimulation is useful to prevent atrophy in denervated Facial Muscles
Gerd F. Volk and Martin Thümmel and Oliver Mothes and Dirk Arnold and Jovanna Thielker and Joachim Denzler and Valeria Mastryukova and Winfried Mayr and Orlando Guntinas-Lichius.
Vienna Workshop on Functional Electrical Stimulation (FESWS).
2019.
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5 patients with facial paralysis received a home-based electrostimulation (ES) with charge-balanced biphasic triangular impulses 3x5min twice a day. Before the first ES, and every 4 weeks during the ES, all patients underwent regular needle electromyography (EMG), ultrasound and 3D-video measurements. Additionally, stimulation settings, patients? home-stimulation diaries and parameters were recorded. No patient reported relevant adverse events linked to ES. Training with optimized electrode positioning was associated with stable and specific zygomaticus muscle activation, accompanied by a reduction of the necessary minimum pulse duration from 250 to 70ms per phase within 16 weeks. Even before reinnervation, objective 3D-videos, sonography, MRI, and patient-related parameters (FDI, FaCE) improved significantly compared to the pre-stimulation situation. Preliminary results suggest that ES home-based training is beneficial for patients with denervated facial muscles in reducing muscle atrophy, maintaining muscle function and improving facial symmetry. A lack of relevant adverse events shows that such ES is safe. The patients showed excellent compliance with the protocol and rated the stimulation easy and effective.
Video Instruction for Synchronous Video Recording of Mimic Movement of Patients with Facial Palsy
Rebecca Anna Schaede and Gerd F. Volk and Luise Modersohn and Jodie M. Barth and Joachim Denzler and Orlando Guntinas-Lichius.
Laryngo-Rhino-Otologie.
2017.
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Background: Photography and video are necessary to record the severity of a facial palsy or to allow offline grading with a grading system. There is no international standard for the video recording urgently needed to allow a standardized comparison of different patient cohorts. Methods: A video instruction was developed. The instruction was shown to the patient and presents several mimic movements. At the same time the patient is recorded while repeating the presented movement using commercial hardware. Facial movements were selected in such a way that it was afterwards possible to evaluate the recordings with standard grading systems (House-Brackmann, Sunnybrook, Stennert, Yanagihara) or even with (semi)automatic software. For quality control, the patients evaluated the instruction using a questionnaire. Results: The video instruction takes 11 min and 05 and is divided in three parts: 1) Explanation of the procedure; 2) Foreplay and recreating of the facial movements; 3) Repeating of sentences to analyze the communication skills. So far 13 healthy subjects and 10 patients with acute or chronic facial palsy were recorded. All recordings could be assessed by the above mentioned grading systems. The instruction was rated as well explaining and easy to follow by healthy persons and patients. Discussion: There is now a video instruction available for standardized recording of facial movement. This instruction is recommended for use in clinical routine and in clinical trials. This will allow a standardized comparison of patients within Germany and international patient cohorts.
Facial Paresis Index Prediction by Exploiting Active Appearance Models for Compact Discriminative Features
Luise Modersohn and Joachim Denzler.
International Conference on Computer Vision Theory and Applications (VISAPP).
Pages 271-278.
2016.
[bibtex]
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In the field of otorhinolaryngology, the dysfunction of the facial nerve is a common disease which results in a paresis of usually one half of the patients face. The grade of paralysis is measured by physicians with rating scales, e.g. the Stennert Index or the House-Brackmann scale. In this work, we propose a method to analyse and predict the severity of facial paresis on the basis of single images. We combine feature extraction methods based on a generative approach (Active Appearance Models) with a fast non-linear classifier (Random Decision Forests) in order to predict the patients grade of facial paresis. In our proposed framework, we make use of highly discriminative features based on the fitting parameters of the Active Appearance Model, Action Units and Landmark distances. We show in our experiments that it is possible to correctly predict the grade of facial paresis in many cases, although the visual appearance is strongly varying. The presented method creates new opportunities to objectively document the patients progress in therapy.
