Visual perception of repaired cleft lip scarring face associated with different malocclusions via eye-tracking

Abstract

Background. This study aimed to evaluate the visual facial perception in response to scars associated with repaired cleft lip (CL) on a male adolescent patient, as assessed via eye-tracking. Methods. Index of orthodontic treatment need (IOTN) malocclusions, grades 1, 5, and 8 were added to the frontal view facial image of an adolescent male model showing asymmetries of the nose and upper lip after CL surgery using the software Photoshop CS5® software. The eye movements of 91 laypeople observers were tracked by an Eye Tribe infrared sensor connected to OGAMA© software. A Kruskal–Wallis test was used to identify differences in total fixation time and time until the first fixation for the areas of interest. A visual analog scale (VAS) of attractiveness was also used in the study. Statistical analysis was performed adopting a significance level of P<0.05. Results. The area of interest (AOI) were found to be the mouth and teeth, which were more focused on gazed at than any other area, regardless of the grade of IOTN. For observers of different ages, there were significant differences in the time until the first fixation on the scar of the repaired CL region for IOTN grade 1 (P=0.007). Images showing IOTN grade 1 repaired CL regions received the highest VAS scores. The older the age, the greater the tendency to give a higher VAS score for the same malocclusion. Conclusion. The presence of a CL scar on the upper lip did not attract the eye of laypeople observers of different ages, regardless of the degree of malocclusion in the non-smile image. The age of the observers did influence the perception of attractiveness, with older observers giving higher scores than younger ones. As the severity of the malocclusion increased, they were found to be less attractive.

The Use of Eye-tracking Technology in Cleft Lip: A Literature Review

“…Only two studies 21,27 used eyetracking glasses rather than screen-based eye-trackers. Chin-rests were used less than half of the time [six studies used chin-rests, 16,[22][23][24]26,30 eight studies did not use chinrests, 15,[17][18][19][20]25,28,29 and two were not applicable (glasses) 21,27 ]. The distance to the screen ranged from 50 to 75 cm; however, this can be dictated by the model of eye-tracker.…”

“…15,17,21,23,24,[26][27][28][29][30] Only eight (50%) studies 19,20,[22][23][24][25][26]29 reported time to first fixation 26,29 (time it took the participant to gaze at target AOI) or initial attention capture 19,20,[22][23][24][25] (first AOI participant gazed at upon stimulus display) data. Three studies 15,25,29 (18.8%) reported fixation sequence/scanpath data (path the eyes moved in while viewing the image) and six 15,18,20,26,27,29 (37.5%) displayed heatmaps of fixations as figures within their articles. Detailed information regarding AOI location of fixations, AOI location of initial interest capture and scanpaths as well as further information about data reporting can be found in Supplemental Digital Content 2 (http:// links.lww.com/PRSGO/C567).…”

“…[23][24][25] Finally, common metrics of data reporting 6 in eyetracking were assessed in the studies selected. All selected studies reported duration of fixation in AOIs, [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] whereas 10 (62.5%) also reported fixation counts in each AOI. 15,17,21,23,24,[26][27][28][29][30] Only eight (50%) studies 19,20,[22][23][24][25][26]29 reported time to first fixation 26,29 (time it took the participant to gaze at target AOI) or initial attention capture 19,20,[22][23][24][25] (first AOI participant gazed at upon stimulus display) data.…”

“…Although 10 publications 15,17,18,20,22,23,25,[28][29][30] asked participants directly to provide a score or asked them questions in addition to the eye-tracking, only four 18,22,28,30 publications provided a comparison of this data to eyetracking data. Of note, Warne et al 19 compared their eye-tracking data to Asher-McDade scores provided by two plastic surgeons who did not participate in eyetracking.…”

Impact of Instagram in the influence on esthetic perception in silhouettes through eye tracking and questionnaire

“…As a result, gaze tracking has been widely used to assess facial perception, including in cases of facial deformities. (Guimaraes et al, 2022) In view of the above findings, the present study aimed to evaluate the time of instagram usage in the attractiveness evaluation of the facial silhouettes of patients who had undergone orthognathic surgery and rhinoplasty. For the present study, the null hypothesis is that there is no difference in attractiveness perception of individuals on silhouette images during the initial, post-orthognathic, and final orthognathic and rhinoplasty periods regardless of instagram usage time.…”