scholarly journals Computerized Sunnybrook facial grading scale (SBface) application for facial paralysis evaluation

2021 ◽  
Vol 48 (3) ◽  
pp. 269-277
Author(s):  
Supasid Jirawatnotai ◽  
Pojanan Jomkoh ◽  
Tsz Yin Voravitvet ◽  
Wuttipong Tirakotai ◽  
Natthawut Somboonsap
Keyword(s):  
Facial Paralysis ◽  
Facial Features ◽  
Intrarater Reliability ◽  
Zero Correlation ◽  
Grading Scale ◽  
Positive Correlations ◽  
Subjective Input ◽  
Composite Scores ◽  
Beta Version ◽  
Good Congruence

Background The Sunnybrook facial grading scale is a comprehensive scale for the evaluation of facial paralysis patients. Its results greatly depend on subjective input. This study aimed to develop and validate an automated Sunnybrook facial grading scale (SBface) to more objectively assess disfigurement due to facial paralysis.Methods An application compatible with iOS version 11.0 and up was developed. The software automatically detected facial features in standardized photographs and generated scores following the Sunnybrook facial grading scale. Photographic data from 30 unilateral facial paralysis patients were randomly sampled for validation. Intrarater reliability was tested by conducting two identical tests at a 2-week interval. Interrater reliability was tested between the software and three facial nerve clinicians.Results A beta version of the SBface application was tested. Intrarater reliability showed excellent congruence between the two tests. Moderate to strong positive correlations were found between the software and an otolaryngologist, including the total scores of the three individual software domains and composite scores. However, 74.4% (29/39) of the subdomain items showed low to zero correlation with the human raters (κ<0.2). The correlations between the human raters showed good congruence for most of the total and composite scores, with 10.3% (4/39) of the subdomain items failing to correspond (κ<0.2).Conclusions The SBface application is efficient and accurate for evaluating the degree of facial paralysis based on the Sunnybrook facial grading scale. However, correlations of the software-derived results with those of human raters are limited by the software algorithm and the raters’ inconsistency.

Application of Intelligent Facial Dynamic Information Image in Warm Acupuncture and Moxibustion on Peripheral Facial Paralysis (Preprint)

2020 ◽  
Author(s):  
Yanping Chen ◽  
Dongjie Yu ◽  
Jane Cansoni
Keyword(s):  
Facial Paralysis ◽  
Computer Technology ◽  
Treatment Time ◽  
Facial Features ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Peripheral Facial Paralysis ◽  
Image Information ◽  
Dynamic Image ◽  
Acupuncture And Moxibustion

BACKGROUND Background: Nowadays, the application of computer technology in the medical field is more and more extensive, and many diseases can achieve better diagnosis and treatment effects through computer technology. OBJECTIVE Objective: The paper applies intelligent facial dynamic image information to the clinical treatment of peripheral acupuncture and moxibustion for the treatment of peripheral facial paralysis. An automatic acupoint positioning algorithm based on facial information dynamic image is proposed, which provides an objective and standard basis for the treatment of facial acupuncture and moxibustion. METHODS Methods: The paper selects the head threshold, that is, the facial dynamic image information as the research background, and divides the facial features according to the "three courts and five eyes" rule, and uses the Minimum Eigenvalue operator to detect the corner points of the facial features, locate the facial features, and use the face. The feature position is used as a reference coordinate for facial acupoint positioning. RESULTS Results: After verification, it was found that the positioning was accurate, and the peripheral facial paralysis of the patient was improved after warm acupuncture point positioning treatment, which improved the facial nerve function of the patient, improved the treatment efficiency and shortened the treatment time. Therefore, this technology is worthy of clinical promotion. CONCLUSIONS Conclusion: Through experimental analysis, the algorithm is proved to be effective and accurate. Based on facial dynamic image information to locate acupoints, warm acupuncture has a significant effect on peripheral facial paralysis, which can significantly improve facial nerve function and shorten treatment time, which is worthy of clinical promotion.

scholarly journals A Critically Appraised Topic on the Tuck Jump Assessment: Does the Tuck Jump Assessment Demonstrate Interrater and Intrarater Reliability in Healthy Individuals?

2020 ◽  
Vol 29 (4) ◽  
pp. 503-508
Author(s):  
Marissa L. Mason ◽  
Marissa N. Clemons ◽  
Kaylyn B. LaBarre ◽  
Nicole R. Szymczak ◽  
Nicole J. Chimera
Keyword(s):  
United States ◽  
The United States ◽  
College Level ◽  
Healthy Individuals ◽  
Intrarater Reliability ◽  
Rater Training ◽  
Bottom Line ◽  
Lower Extremity Injuries ◽  
Extremity Injuries ◽  
Composite Scores

Clinical Scenario: Lower-extremity injuries in the United States costs millions of dollars each year. Athletes should be screened for neuromuscular deficits and trained to correct them. The tuck jump assessment (TJA) is a plyometric tool that can be used with athletes. Clinical Question: Does the TJA demonstrate both interrater and intrarater reliability in healthy individuals? Summary of Key Findings: Four of the 5 articles included in this critically appraised topic showed good to excellent reliability; however, caution should be taken in interpreting these results. Although composite scores of the TJA were found to be reliable, individual flaws do not demonstrate reliability on their own, with the exception of knee valgus at landing. Aspects of the TJA itself, including rater training, scoring system, playback speed, volume, and number of views allotted, need to be standardized before the reliability of this clinical assessment can be further researched. Clinical Bottom Line: The TJA has shown varying levels of reliability, from poor to excellent, for both interrater and intrarater reliability, given current research. Strength of Recommendation: According to the Centre for Evidence Based Medicine levels of evidence, there is level 2b evidence for research into the reliability of the TJA. This evidence has been demonstrated in elite, adolescent, and college-level athletics in the United Kingdom, Spain, and the United States. The recommendation of level 2b was chosen because these studies utilized cohort design for interrater and intrarater reliability across populations. An overall grade of B was recommended because there were consistent level 2 studies.

scholarly journals Comprehensive Facial Rehabilitation Improves Function in People With Facial Paralysis: A 5-Year Experience at the Massachusetts Eye and Ear Infirmary

2010 ◽  
Vol 90 (3) ◽  
pp. 391-397 ◽  
Author(s):  
Robin W. Lindsay ◽  
Mara Robinson ◽  
Tessa A. Hadlock
Keyword(s):  
Facial Nerve ◽  
Facial Paralysis ◽  
Physical Therapist ◽  
Tertiary Care ◽  
Average Score ◽  
Home Program ◽  
Grading Scale ◽  
Initial Score ◽  
Facial Function ◽  
Facial Rehabilitation

Background The Facial Grading Scale (FGS) is a quantitative instrument used to evaluate facial function after facial nerve injury. However, quantitative improvements in function after facial rehabilitation in people with chronic facial paralysis have not been shown. Objective The objectives of this study were to use the FGS in a large series of consecutive subjects with facial paralysis to quantitatively evaluate improvements in facial function after facial nerve rehabilitation and to describe the management of chronic facial paralysis. Design The study was a retrospective review. Methods A total of 303 individuals with facial paralysis were evaluated by 1 physical therapist at a tertiary care facial nerve center during a 5-year period. Facial rehabilitation included education, neuromuscular training, massage, meditation-relaxation, and an individualized home program. After 2 months of home exercises, the participants were re-evaluated, and the home program was tailored as necessary. All participants were evaluated with the FGS before the initiation of facial rehabilitation, and 160 participants were re-evaluated after receiving treatment. All participants underwent the initial evaluation at least 4 months after the onset of facial paralysis; for 49 participants, the evaluation took place more than 3 years after onset. Results Statistically significant increases in FGS scores were seen after treatment (P&lt;.001, t test). The average initial score was 56 (SD=21, range=13–98), and the average score after treatment was 70 (SD=18, range=25–100). Limitations A limitation of this study was that evaluations were performed by only 1 therapist. Conclusions For 160 patients with facial paralysis, statistically significant improvements after facial rehabilitation were shown; the improvements appeared to be long lasting with continued treatment. The improvements in the FGS scores indicated that patients can successfully manage symptoms with rehabilitation and underscored the importance of specialized therapy in the management of facial paralysis.

scholarly journals Interrater and intrarater reliability of the Knosp scale for pituitary adenoma grading

2017 ◽  
Vol 126 (5) ◽  
pp. 1714-1719 ◽  
Author(s):  
Michael A. Mooney ◽  
Douglas A. Hardesty ◽  
John P. Sheehy ◽  
Robert Bird ◽  
Kristina Chapple ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Interrater Reliability ◽  
Pituitary Surgery ◽  
Full Scale ◽  
Intrarater Reliability ◽  
Percent Agreement ◽  
Significant Difference ◽  
Mri Scans ◽  
Grading Scale ◽  
Common Clinical Practice

OBJECTIVEThe goal of this study was to determine the interrater and intrarater reliability of the Knosp grading scale for predicting pituitary adenoma cavernous sinus (CS) involvement.METHODSSix independent raters (3 neurosurgery residents, 2 pituitary surgeons, and 1 neuroradiologist) participated in the study. Each rater scored 50 unique pituitary MRI scans (with contrast) of biopsy-proven pituitary adenoma. Reliabilities for the full scale were determined 3 ways: 1) using all 50 scans, 2) using scans with midrange scores versus end scores, and 3) using a dichotomized scale that reflects common clinical practice. The performance of resident raters was compared with that of faculty raters to assess the influence of training level on reliability.RESULTSOverall, the interrater reliability of the Knosp scale was “strong” (0.73, 95% CI 0.56–0.84). However, the percent agreement for all 6 reviewers was only 10% (26% for faculty members, 30% for residents). The reliability of the middle scores (i.e., average rated Knosp Grades 1 and 2) was “very weak” (0.18, 95% CI −0.27 to 0.56) and the percent agreement for all reviewers was only 5%. When the scale was dichotomized into tumors unlikely to have intraoperative CS involvement (Grades 0, 1, and 2) and those likely to have CS involvement (Grades 3 and 4), the reliability was “strong” (0.60, 95% CI 0.39–0.75) and the percent agreement for all raters improved to 60%. There was no significant difference in reliability between residents and faculty (residents 0.72, 95% CI 0.55–0.83 vs faculty 0.73, 95% CI 0.56–0.84). Intrarater reliability was moderate to strong and increased with the level of experience.CONCLUSIONSAlthough these findings suggest that the Knosp grading scale has acceptable interrater reliability overall, it raises important questions about the “very weak” reliability of the scale's middle grades. By dichotomizing the scale into clinically useful groups, the authors were able to address the poor reliability and percent agreement of the intermediate grades and to isolate the most important grades for use in surgical decision making (Grades 3 and 4). Authors of future pituitary surgery studies should consider reporting Knosp grades as dichotomized results rather than as the full scale to optimize the reliability of the scale.

scholarly journals paraFaceTest: an ensemble of regression tree-based facial features extraction for efficient facial paralysis classification

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jocelyn Barbosa ◽  
Woo-Keun Seo ◽  
Jaewoo Kang
Keyword(s):  
Facial Paralysis ◽  
Regression Tree ◽  
Features Extraction ◽  
Facial Features

ELECTROMYOGRAPHIC REHABILITATION OF FACIAL FUNCTION AND INTRODUCTION OF A FACIAL PARALYSIS GRADING SCALE FOR HYPOGLOSSAL-FACIAL NERVE ANASTOMOSIS

1988 ◽  
Vol 98 (4) ◽  
pp. 405???410 ◽  
Author(s):  
JOSEPH BRUDNY ◽  
PAUL E. HAMMERSCHLAG ◽  
NOEL L. COHEN ◽  
JOSEPH RANSOHOFF
Keyword(s):  
Facial Nerve ◽  
Facial Paralysis ◽  
Nerve Anastomosis ◽  
Grading Scale ◽  
Facial Function

The Effects of Nasoalveolar Molding on Nasal Proportions at the Time of Nasal Maturity

2020 ◽  
pp. 105566562095013
Author(s):  
Samantha G. Maliha ◽  
Rami S. Kantar ◽  
Marina N. Gonchar ◽  
Bradley S. Eisemann ◽  
David A. Staffenberg ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Surgical Repair ◽  
Intrarater Reliability ◽  
Exclusion Criteria ◽  
Subjective Analysis ◽  
Nasolabial Angle ◽  
Syndromic Diagnosis ◽  
Grading Scale ◽  
Nasoalveolar Molding

Background: The aim of this study is to assess the effect of nasoalveolar molding (NAM) versus no-NAM on nasal morphology in patients with unilateral cleft lip and palate (UCLP) at the time of nasal maturity. Methods: A retrospective, single-institution review was conducted on all non-syndromic patients with UCLP. Inclusion criteria included age 14 years or above, unilateral cleft repair at the time of infancy, and adequate photography taken at nasal maturity and prior to rhinoplasty. Exclusion criteria included age less than 14 years, syndromic diagnosis, and rhinoplasty prior to nasal maturity. Ten parameters were measured twice from standardized clinical photographs using the Dolphin Imaging Software for establishment of intrarater reliability. Subjective analysis was achieved through completion of the Asher McDade grading scale by 3 expert cleft practitioners. Results: Nostril height, columellar angle, alar cant, vertical alar height, alar height angle, nasofacial angle, and nasolabial angle were found to be significantly less severe in patients who had undergone NAM in conjunction with surgical repair when compared with those who had undergone surgical repair alone. Asher McDade grading revealed significant improvement in nasal form, nasal symmetry/deviation, nasal profile, vermillion border, and overall score in patients who underwent NAM compared to no-NAM. Conclusion: The use of presurgical NAM during infancy can improve nasal symmetry and nasal proportions at the time of nasal maturity.

scholarly journals Masseteric–facial nerve neurorrhaphy: results of a case series

2017 ◽  
Vol 126 (1) ◽  
pp. 312-318 ◽  
Author(s):  
Federico Biglioli ◽  
Valeria Colombo ◽  
Dimitri Rabbiosi ◽  
Filippo Tarabbia ◽  
Federica Giovanditto ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Facial Paralysis ◽  
Postoperative Bleeding ◽  
Case Series ◽  
Morbidity Rate ◽  
Nerve Function ◽  
Facial Reanimation ◽  
Grade Ii ◽  
Grading Scale ◽  
Masseteric Nerve

OBJECTIVE Facial palsy is a well-known functional and esthetic problem that bothers most patients and affects their social relationships. When the time between the onset of paralysis and patient presentation is less than 18 months and the proximal stump of the injured facial nerve is not available, another nerve must be anastomosed to the facial nerve to reactivate its function. The masseteric nerve has recently gained popularity over the classic hypoglossus nerve as a new motor source because of its lower associated morbidity rate and the relative ease with which the patient can activate it. The aim of this work was to evaluate the effectiveness of masseteric–facial nerve neurorrhaphy for early facial reanimation. METHODS Thirty-four consecutive patients (21 females, 13 males) with early unilateral facial paralysis underwent masseteric–facial nerve neurorrhaphy in which an interpositional nerve graft of the great auricular or sural nerve was placed. The time between the onset of paralysis and surgery ranged from 2 to 18 months (mean 13.3 months). Electromyography revealed mimetic muscle fibrillations in all the patients. Before surgery, all patients had House-Brackmann Grade VI facial nerve dysfunction. Twelve months after the onset of postoperative facial nerve reactivation, each patient underwent a clinical examination using the modified House-Brackmann grading scale as a guide. RESULTS Overall, 91.2% of the patients experienced facial nerve function reactivation. Facial recovery began within 2–12 months (mean 6.3 months) with the restoration of facial symmetry at rest. According to the modified House-Brackmann grading scale, 5.9% of the patients had Grade I function, 61.8% Grade II, 20.6% Grade III, 2.9% Grade V, and 8.8% Grade VI. The morbidity rate was low; none of the patients could feel the loss of masseteric nerve function. There were only a few complications, including 1 case of postoperative bleeding (2.9%) and 2 local infections (5.9%), and a few patients complained about partial loss of sensitivity of the earlobe or a small area of the ankle and foot, depending on whether great auricular or sural nerves were harvested. CONCLUSIONS The surgical technique described here seems to be efficient for the early treatment of facial paralysis and results in very little morbidity.

Temporal Bone Trauma and Facial Paralysis

1979 ◽  
Vol 12 (2) ◽  
pp. 403-413
Author(s):  
Roger C. Lindeman
Keyword(s):  
Temporal Bone ◽  
Facial Paralysis ◽  
Bone Trauma

Facial Paralysis of Central Nervous System Origin

1974 ◽  
Vol 7 (2) ◽  
pp. 411-424
Author(s):  
James R. Nelson
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Facial Paralysis
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