Automated objective and marker-free facial grading using photographs of patients with facial palsy

Mothes, Oliver; Modersohn, Luise; Volk, Gerd Fabian; Klingner, Carsten M.; Witte, Otto W.; Denzler, Joachim; Guntinas‐Lichius, Orlando

doi:10.1007/s00405-019-05647-7

Cited by 30 publications

(26 citation statements)

References 26 publications

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“…A few markerless computing analyses studies have recently been reported [20][21][22][23], and three-dimensional techniques have been used to document the facial motions [10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

“…The strength of the present study is that the markerless analysis has been assessed on the video recordings of the subjects already classified and validated as HB grade in previous studies [15,16], combining the objective marker analysis with two traditional clinical classification (HBGS and SBGS). A similar markerless study based on the software learning and tree decision has recently been reported [22]; however, photograms instead of videoclips were used, increasing the risk of not exactly quantifying the point distances during the face movements.…”

Section: Discussionmentioning

confidence: 99%

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An objective, markerless videosystem for staging facial palsy

Monini

Ripoli

Filippi

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose To propose a new objective, video recording method for the classification of unilateral peripheral facial palsy (UPFP) that relies on mathematical algorithms allowing the software to recognize numerical points on the two sides of the face surface that would be indicative of facial nerve impairment without positioning of markers on the face. Methods Patients with UPFP of different House–Brackmann (HB) degrees ranging from II to V were evaluated after video recording during two selected facial movements (forehead frowning and smiling) using a software trained to recognize the face points as numbers. Numerical parameters in millimeters were obtained as indicative values of the shifting of the face points, of the shift differences of the two face sides and the shifting ratio between the healthy (denominator) and the affected side (numerator), i.e., the asymmetry index for the two movements. Results For each HB grade, specific asymmetry index ranges were identified with a positive correlation for shift differences and negative correlation for asymmetry indexes. Conclusions The use of the present objective system enabled the identification of numerical ranges of asymmetry between the healthy and the affected side that were consistent with the outcome from the subjective methods currently in use.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

An objective, markerless videosystem for staging facial palsy

Monini

Ripoli

Filippi

et al. 2021

Eur Arch Otorhinolaryngol

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“…Kochhar et al revealed an objective reduction of facial asymmetry and improved lip excursions for smiling after hypoglossal-facial jump nerve suture. Recently, we have introduced an automated tool based on a machine learning approach for objective facial action coding and another tool for objective grading of patients with facial palsy (28,29). An important next task will be to apply these objective tools also for evaluation of the patients after hypoglossal-facial jump nerve suture.…”

Section: Discussionmentioning

confidence: 99%

Functional Outcome and Quality of Life After Hypoglossal-Facial Jump Nerve Suture

et al. 2020

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Background: To evaluate the face-specific quality of life after hypoglossal-facial jump nerve suture for patients with long-term facial paralysis. Methods: A single-center retrospective cohort study was performed. Forty-one 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 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.

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“…After the measurement, the data were transferred to a computer and then evaluated and compared with the clinical results from the Yanagihara and House-Brackmann grading scales, whereby a good correlation could be demonstrated [18]. Furthermore, several machine learning approaches [19][20][21] have been developed. Despite all efforts in the description and validation of various systems, none could achieve universal acceptance in everyday clinical practice.…”

Section: Current Methods For Quantifying Facial Palsymentioning

confidence: 99%

“…Hardware components of the TrueDepth camera system, which is integrated in the upper part of the smartphone. A Dot Projector throws over 30,000 infrared dots onto the face of the user, and the dots and an infrared image are captured via an infrared camera to create a depth map of the face (modified from [20]).…”

Section: Smartphone Sensors As Sophisticated Medical Toolsmentioning

confidence: 99%

Utilization of Smartphone Depth Mapping Cameras for App-Based Grading of Facial Movement Disorders: Development and Feasibility Study (Preprint)

Taeger¹,

Bischoff²,

Hagen³

et al. 2020

Preprint

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BACKGROUND For the classification of facial palsy, various efforts have been made for the description and evaluation of clinician-graded and software-based scoring systems. They serve the purpose of scientific and clinical assessment of the spontaneous course of the disease or monitoring therapeutic interventions. Nevertheless, none of them could achieve universal acceptance in everyday clinical practice. Hence, a quick and precise tool for assessing the functional status of the facial nerve would be desirable. In this context, the possibilities that depth mapping cameras of recent smartphones offer have sparked our interest. OBJECTIVE This study describes the utilization of a smartphone’s depth mapping camera via a specially developed app prototype for a quick, objective and reproducible quantification of facial asymmetries. METHODS After conceptual and user interface design a native app prototype for iOS was programmed, that accesses and processes the data of the TrueDepth-camera. Using a special algorithm, the app returns a new index for the grading of unilateral facial palsy ranging from 0% to 100%, called Digital Facial Index. The algorithm was adapted to the well-established Stennert’s index by weighting the individual facial regions based on functional and cosmetic aspects. Test measurements were performed in order to proof the reliability of the system. RESULTS The app prototype turned out to be stable and met all of the criteria previously defined. The newly defined index expresses the results of the measurement as an easily understandable numerical value for each half of the face. Test measurements were reproducible and revealed no statistically significant intertest variability. CONCLUSIONS The use of a smartphone’s depth mapping camera has considerable potential for the app-based grading of facial movement disorders. The app and its algorithm, which is based on theoretical considerations, should be checked in a prospective clinical study and correlated with common facial scores.

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Automated objective and marker-free facial grading using photographs of patients with facial palsy

Cited by 30 publications

References 26 publications

An objective, markerless videosystem for staging facial palsy

An objective, markerless videosystem for staging facial palsy

Functional Outcome and Quality of Life After Hypoglossal-Facial Jump Nerve Suture

Utilization of Smartphone Depth Mapping Cameras for App-Based Grading of Facial Movement Disorders: Development and Feasibility Study (Preprint)

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