Facial Mobility and Recovery in Patients with Unilateral Facial Paralysis

Authors: Carroll Ann Trotman, Julian Faraway, Tessa Hadlock

Abstract

Objective

To quantify longitudinal 3D changes in facial soft tissue movements in a group of adults with unilateral facial paralysis who were expected to recover over a 12 week period, and (b) to compare the patients’ movements with an age- and sex-frequency matched control group.

Settings and Sample Population

Prospective 3D facial movement data of 36 patients and 68 control participants.

Materials and Methods

3D facial soft tissue movement data were collected from participants during different facial animations. Mean group measurements of displacement, velocity, and asymmetry were computed. Two sample t-tests were used to test for significant group differences, and linear mixed models were fit to test for significant changes over time in the patient group. Also, dynamic modeling and vector plots were computed to isolate the patients’ abnormal movements and/or paralysis.

Results

The patients’ mean baseline movements were significantly less for both the paralyzed and

unaffected sides of the face with much greater movement asymmetry than the controls. Patients’ mean measures improved significantly from baseline to 12 weeks. The measures were closer to, but fell short of, the control values.

Conclusion

In unilateral facial paralysis, the non-paralyzed facial side is affected by the paralysis and is tethered or limited in its movement by the paralyzed side. The comprehensive measurement set and 3D facial mapping effectively tracked patient recovery and isolated paralyzed facial regions. The new 3D measures can be used for diagnosis and outcome assessment of different treatments.

Supplemental Material

Control Movies

Note that these movies are in Quicktime format and may not play within your browser. You may need to download them to play with VLC (for example)

Static vector plots showing extent of maximum motion

Example Subject

Shows maximum smile at