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New method to evaluate sequelae of static facial asymmetry in patients with facial palsy using three-dimensional scanning analysis

  • Author Footnotes
    1 These two authors contributed equally to this work
    Takahiro Azuma
    Footnotes
    1 These two authors contributed equally to this work
    Affiliations
    Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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  • Author Footnotes
    1 These two authors contributed equally to this work
    Teruhiko Fuchigami
    Footnotes
    1 These two authors contributed equally to this work
    Affiliations
    Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan

    Department of Otolaryngology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
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  • Katsuhiko Nakamura
    Affiliations
    Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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  • Eiji Kondo
    Affiliations
    Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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  • Go Sato
    Affiliations
    Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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  • Yoshiaki Kitamura
    Affiliations
    Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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  • Noriaki Takeda
    Correspondence
    Corresponding author at: Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
    Affiliations
    Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
    Search for articles by this author
  • Author Footnotes
    1 These two authors contributed equally to this work
Published:January 29, 2022DOI:https://doi.org/10.1016/j.anl.2022.01.007

      Abstract

      Objective

      During the process of neural recovery after facial palsy, distressing sequelae of static and dynamic facial asymmetry develop in patients with facial palsy. A pronounced nasolabial fold is mainly responsible for static facial asymmetry, which leads to many psychological and social problems in patients. Objective and qualitative assessment of facial appearance is critical to determine the severity of sequelae of static facial asymmetry and whether an intervention is effective for treatment. In the present study, an attempt was made to develop three-dimensional analysis method to assess sequelae of static facial asymmetry after facial palsy.

      Methods

      Eight patients with sequelae of facial asymmetry after facial palsy and ten healthy volunteers were enrolled. We used three-dimensional scanning analysis with a portable non-contact optical scanner to obtain three-dimensional surface data from a patient's face and produced a three-dimensional digital model of the face. We then identified a reference plane fixed with the patient's face, and measured the depth of the nasolabial fold of the face.

      Results

      The nasolabial fold of the face on the affected side was significantly deeper than that on the unaffected side in patients with sequelae of static facial asymmetry after facial palsy. However, the depth of the facial nasolabial fold on the right side was not different from that on the left side in healthy volunteers. Affected-unaffected side differences in the depth of the nasolabial fold in patients with sequelae of static facial asymmetry after facial palsy were significantly larger than left-right differences in the depth of the nasolabial fold in healthy volunteers. Two weeks after treatment with botulinum toxin injection to the affected zygomaticus muscles, affected-unaffected side differences in the depth of the nasolabial fold were significantly decreased in the patients. In the patients who received botulinum toxin, the absolute values of affected-unaffected side differences in the depth of the nasolabial fold measured using the three-dimensional scanning analysis showed a significant positive correlation with the visual analog scale scores of facial asymmetry marked by independent doctors.

      Conclusion

      The present findings suggest that affected-unaffected side differences in the depth of the nasolabial fold of the measured using three-dimensional scanning analysis can be used as an index of sequelae of static facial asymmetry. It is also suggested that the index can evaluate whether interventions are effective for the treatment of sequelae.

      Keywords

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