The capability to perform facial analysis from video sequences has significant potential to positively impact in many areas of life. One such area relates to the medical domain to specifically aid in the diagnosis and rehabilitation of patients with facial palsy. With this application in mind, this paper presents an end-to-end framework, named 3DPalsyNet, for the tasks of mouth motion recognition and facial palsy grading. 3DPalsyNet utilizes a 3D CNN architecture with a ResNet backbone for the prediction of these dynamic tasks. Leveraging transfer learning from a 3D CNNs pre-trained on the Kinetics data set for general action recognition, the model is modified to apply joint supervised learning using center and softmax loss concepts. 3DPalsyNet is evaluated on a test set consisting of individuals with varying ranges of facial palsy and mouth motions and the results have shown an attractive level of classification accuracy in these tasks of 82% and 86% respectively. The frame duration and the loss function affect was studied in terms of the predictive qualities of the proposed 3DPalsyNet, where it was found shorter frame duration's of 8 performed best for this specific task. Centre loss and softmax have shown improvements in spatio-temporal feature learning than softmax loss alone, this is in agreement with earlier work involving the spatial domain.

pdf/3dpalsynet-a-facial-palsy-grading-and-motion-recognition-lec0y0k02m.pdf

3DPalsyNet:A Facial Palsy Grading and Motion Recognition Framework Using Fully 3D Convolutional Neural Networks

Myoplastie d'allongement du temporal L'utilisation du muscle temporal pour reanimer la levre est une technique ancienne : utilisation partielle de Gillies [1] 1934, bascule par dessus le zygoma vers la levre dans le plan sous-cutane. Mac Laughlin [2] en 1952 avait propose un relais entre tendon du temporal et levres ; ce relais aponevrotique qui risquait de s'allonger et de necroser etait la principale cause d'echec a long terme de cette technique. En s'inspirant de Mac Laughlin, la myoplastie d'allongement abaisse le muscle temporal dans son ensemble en descendant le tendon jusque sur la levre et en obtenant un allongement aux depens de la moitie posterieure.

Lengthening temporalis myoplasty

BACKGROUND Lengthening temporalis myoplasty (LTM) and cross-face nerve graft with free gracilis muscle transfer (CFNG-FGMT) are the 2 most common procedures used to restore dynamic facial animation and improve facial symmetry. There has not been direct comparison or consensus. Here, the authors compare our experience with respect to muscle activity, symmetry, and excursion. METHODS A retrospective review was performed of patients with facial palsy who had CFNG-FGMT or LTM from 2008 to 2016 at a single institution. Postoperative surface EMG was recorded at maximum open smile. Normal and paralyzed sides of the face were analyzed with Facial Assessment by Computer Evaluation software. Commissure excursion and symmetry was assessed. RESULTS Six patients with LTM and 10 with CFNG-FGMT met inclusion criteria. Muscle activity was 1st identified in LTM patients after 3 months (47.42 mV, P < 0.001) and CFNG-FGMT patients after 3 months (28.30 mV, P < 0.001) compared to immediate postoperative period. Relative to preoperative excursion, there was significant increase of 3.33 mm in commissure excursion seen at the 0 to 3 month period for LTM patients (P = 0.04). Commisure excursion for CFNG-FGMT was seen later, in the 3- to 6-month postoperative period (4.01, P = 0.024). During smile, CFNG-FGMT patients had better symmetry than unilateral LTM patients. In bilateral LTM patients, there was no significant change in symmetry. CONCLUSION Dynamic facial animation improved in both surgical groups. The LTM demonstrates a faster rate of muscle recruitment compared to CFNG-FGMT. After 3 months, both LTM and CFNG-FGMT groups had comparable excursions. A decision-making algorithm is presented.

Comparison of Lengthening Temporalis Myoplasty and Free-Gracilis Muscle Transfer for Facial Reanimation in Children

Objective Evaluate outcomes of the lengthening temporalis myoplasty in facial reanimations. Study Design Case series with planned data collection. Setting Ospedali Riuniti, Bergamo, and AOUC Careggi, Florence, Italy. Subjects and Methods From 2011 to 2016, 11 patients underwent lengthening temporalis myoplasty; demographic data were collected for each. Pre- and postoperative photographs and videos were recorded and used to measure the smile angle and the excursion of the oral commissure, according to the SMILE system (Scaled Measurements of Improvement in Lip Excursion). All patients were tested with the Facial Disability Index, and they also completed a questionnaire about the adherence to physiotherapy indications. Results All patients demonstrated a significant improvement in functional parameters and in quality of life. On the reanimated side, the mean z-line and a-value, measured when smiling, significantly improved in all patients: from 22.6 mm (95% CI, 20.23-25.05) before surgery to 30.9 mm (95% CI, 27.82-33.99) after surgery ( P < .001) and from 100.5° (95% CI, 93.96°-107.13°) to 111.6° (95% CI, 105.63°-117.64°; P < .001), respectively. The mean postoperative dynamic gain, passing from rest to a full smile at the reanimated side, was 3.1 mm (95% CI, 1.30-4.88) for the z-line and 3.3° (95% CI, 1.26°-5.29°) for the a-value. The Facial Disability Index score increased from a preoperative mean of 33.4 points (95% CI, 28.25-38.66) to 49.9 points (95% CI, 47.21-52.60) postoperatively ( P < .001). Conclusions The lengthening temporalis myoplasty can be successfully used for smile reanimation, with satisfying functional and quality-of-life outcomes.

/pdf/lengthening-temporalis-myoplasty-objective-outcomes-and-site-517263yew4.pdf

Lengthening Temporalis Myoplasty: Objective Outcomes and Site-Specific Quality-of-Life Assessment:

The capability to perform facial analysis from video sequences has significant potential to positively impact in many areas of life. One such area relates to the medical domain to specifically aid in the diagnosis and rehabilitation of patients with facial palsy. With this application in mind, this paper presents an end-to-end framework, named 3DPalsyNet, for the tasks of mouth motion recognition and facial palsy grading. 3DPalsyNet utilizes a 3D CNN architecture with a ResNet backbone for the prediction of these dynamic tasks. Leveraging transfer learning from a 3D CNNs pre-trained on the Kinetics data set for general action recognition, the model is modified to apply joint supervised learning using center and softmax loss concepts. 3DPalsyNet is evaluated on a test set consisting of individuals with varying ranges of facial palsy and mouth motions and the results have shown an attractive level of classification accuracy in these task of 82% and 86% respectively. The frame duration and the loss function affect was studied in terms of the predictive qualities of the proposed 3DPalsyNet, where it was found shorter frame duration's of 8 performed best for this specific task. Centre loss and softmax have shown improvements in spatio-temporal feature learning than softmax loss alone, this is in agreement with earlier work involving the spatial domain.

3DPalsyNet: A Facial Palsy Grading and Motion Recognition Framework using Fully 3D Convolutional Neural Networks.

Facial palsy (FP) in children is congenital or acquired. When present at birth (congenital), etiologies are mostly traumatic and rarely developmental. Acquired FP needs investigation. Research on the etiology helps to determine prognostic and treatment. At most times, no specific cause is found. Treatment of idiopathic FP consists of early oral corticosteroid therapy and ocular protection. Treating the sequelae is essential and the physician has to consider the dynamic balance of both sides of the face. Dynamic rehabilitation should mainly concern the inferior facial third. We recommend the lengthening temporalis myoplasty (LTM). This relevant technique ensures replicable and reliable results with a harmonious smile. Facial dynamic rehabilitation after surgical procedure (muscle tranfer or free muscle flap) must be directed toward control of voluntary movement, to move from a mandibular smile to a spontaneous and voluntary smile, thanks to brain plasticity. Furthermore, botulinum toxin is well tolerated and remains a great tool to treat a child who can support injections.

Facial palsy in children

Re: 'Lenghtening temporalis myoplasty: Outcome and radiographic anatomical evaluation of length required'.

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Facial palsy in children

Re: 'Lenghtening temporalis myoplasty: Outcome and radiographic anatomical evaluation of length required'.