Advanced Statistical Analysis of 3D Kinect Data: Mimetic Muscle Rehabilitation Following Head and Neck Surgeries Causing Facial Paresis

An advanced statistical analysis of patients’ faces after specific surgical procedures that temporarily negatively affect the patient’s mimetic muscles is presented. For effective planning of rehabilitation, which typically lasts several months, it is crucial to correctly evaluate the improvement of the mimetic muscle function. The current way of describing the development of rehabilitation depends on the subjective opinion and expertise of the clinician and is not very precise concerning when the most common classification (House–Brackmann scale) is used. Our system is based on a stereovision Kinect camera and an advanced mathematical approach that objectively quantifies the mimetic muscle function independently of the clinician’s opinion. To effectively deal with the complexity of the 3D camera input data and uncertainty of the evaluation process, we designed a three-stage data-analytic procedure combining the calculation of indicators determined by clinicians with advanced statistical methods including functional data analysis and ordinal (multiple) logistic regression. We worked with a dataset of 93 distinct patients and 122 sets of measurements. In comparison to the classification with the House–Brackmann scale the developed system is able to automatically monitor reinnervation of mimetic muscles giving us opportunity to discriminate even small improvements during the course of rehabilitation.

Intramuscular Insertion of a Radiofrequency Microneedling Device for Facial Rejuvenation: A New Technique and Case Reports

Skin laxity and dynamic rhytids that signify facial aging are due, in part, to atrophic changes and volume redistribution in the underlying layers of the face: the bone and soft tissue. A microneedling device that delivers bipolar radiofrequency (RF) energy directly to the reticular dermis has been shown to yield rejuvenated, tighter skin in 100% of patients. Herein, the author describes a modification to the standard dermal technique in which the skin is gently gathered with the nondominant hand, and the microneedling device is tilted to deliver RF energy to the mimetic muscles—including the frontalis, orbicularis oculi, and orbicularis oris—as well as the dermis. Muscle penetration was inferred by intraoperative bleeding and postoperative bruising, neither of which is typical of standard RF microneedling. Preliminary findings suggest that the modified procedure may yield greater aesthetic benefits than achieved with dermal application alone, including subtle lifting of the brow and oral commissure, upper-lip shortening with vermilion eversion, tightening of the lower-lid fat pads, and reduction in lateral-canthal rhytids. Although this modified technique will need to be optimized and evaluated in large, controlled studies, the initial results presented herein are encouraging. Level of Evidence: 5

Ayurvedic management of Bells Palsy - A Case Report

Bells palsy an acute paresis of facial mimetic muscles is most common in the third decade of life with an incidence of about 20 cases per 1,00,000 population. The complete recovery rates within 3 months vary from 80-85%. Major complications of the condition include chronic loss of taste, chronic facial spasm, facial pain, corneal infections making early intervention essential. Ardita clinically correlates to Bells palsy. Its cause is mainly vitiated Vata due to Avarana or Dhatukshaya and management is primarily based on Vatahara and Urdhva Sharira Chikitsa. Methods: The current report is based on a case of Bells palsy that presented as left sided facial paresis with deviated angle of mouth to the right, diagnosed as Ardita due to Vata and Kapha Anubandha. Treatment included Nasya Karma, Shiro Pichu, Mukhabhyanga followed by Panasa Patra Sweda and internal medications. Result: Improvement in motor functioning was noticed from day 3 of treatment. Speech enhancement and sensory perception was also noted. Discussion: Ayurvedic management with Ardita Chikitsa provided brisk results in this case.

Muscles of Facial Expression in Extinct Species of the Genus Homo

ABSTRACTWe display a detailed description of mimetic muscles in extinct human species, framed in comparative and phylogenetic contexts. Using known facial landmarks, we assessed the arrangement of muscles of facial expression in Homo sapiens, neanderthalensis, erectus, heidelbergensis and ergaster. In modern humans, several perioral muscles are proportionally smaller in size (levator labii superioris, zygomaticus minor, zygomaticus major and triangularis) and/or located more medially (levator labii superioris, zygomaticus minor and quadratus labii inferioris) than in other human species. As mimetic musculature is examined in the most ancient specimens up to the most recent, there is a general trend towards an increase in size of corrugator supercillii and triangularis. Homo ergaster’s mimetic musculature closely resembles modern Homo, both in size and in location; furthermore, Homo erectus and Homo neanderthalensis share many muscular features. The extinct human species had an elaborate and highly graded facial communication system, but it remained qualitatively different from that reported in modern Homo. Compared with other human species, Homo sapiens clearly exhibits a lower degree of facial expression, possibly correlated with more sophisticated social behaviours and with enhanced speech capabilities. The presence of anatomical variation among species of the genus Homo raises important questions about the possible taxonomic value of mimetic muscles.