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Ikezawa N, Okamoto T, Yoshida Y, Kurihara S, Takahashi N, Nakada TA, Haneishi H. Toward an application of automatic evaluation system for central facial palsy using two simple evaluation indices in emergency medicine. Sci Rep 2024; 14:3429. [PMID: 38341480 PMCID: PMC10858878 DOI: 10.1038/s41598-024-53815-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 02/05/2024] [Indexed: 02/12/2024] Open
Abstract
A stroke is a medical emergency and thus requires immediate treatment. Paramedics should accurately assess suspected stroke patients and promptly transport them to a hospital with stroke care facilities; however, current assessment procedures rely on subjective visual assessment. We aim to develop an automatic evaluation system for central facial palsy (CFP) that uses RGB cameras installed in an ambulance. This paper presents two evaluation indices, namely the symmetry of mouth movement and the difference in mouth shape, respectively, extracted from video frames. These evaluation indices allow us to quantitatively evaluate the degree of facial palsy. A classification model based on these indices can discriminate patients with CFP. The results of experiments using our dataset show that the values of the two evaluation indices are significantly different between healthy subjects and CFP patients. Furthermore, our classification model achieved an area under the curve of 0.847. This study demonstrates that the proposed automatic evaluation system has great potential for quantitatively assessing CFP patients based on two evaluation indices.
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Affiliation(s)
- Naoki Ikezawa
- Graduate School of Science and Engineering, Chiba University, Chiba, Japan
| | - Takayuki Okamoto
- Center for Frontier Medical Engineering, Chiba University, Chiba, Japan.
| | - Yoichi Yoshida
- Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Satoru Kurihara
- Department of Neurosurgery, Narita Red Cross Hospital, Chiba, Japan
| | - Nozomi Takahashi
- Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Taka-Aki Nakada
- Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hideaki Haneishi
- Center for Frontier Medical Engineering, Chiba University, Chiba, Japan
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Fuzi J, Meller C, Ch'ng S, Dusseldorp J. The Emerging Role of Artificial Intelligence Tools for Outcome Measurement in Facial Reanimation Surgery: A Review. Facial Plast Surg Aesthet Med 2023; 25:556-561. [PMID: 37782135 DOI: 10.1089/fpsam.2022.0424] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Abstract
Importance: Surgeons treating facial paralysis with reanimation surgery measure the outcomes of surgery and adjust treatment to each patient's needs. Our objective is to review the current subjective facial paralysis assessment tools and the emerging computer-based objective analysis, which may involve artificial intelligence. Observations: In recent years, many new automated approaches to outcome measurement in facial reanimation surgery have been developed. Most of these tools utilize artificial intelligence to analyze emotional expression and symmetry of facial landmarks. Other tools have provided automated approaches to existing clinician-guided scales. Conclusions: Newly developed computer-based tools using artificial intelligence have been developed to both improve existing clinician-graded scales and provide new approaches to facial symmetry and emotional expressivity analysis.
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Affiliation(s)
- Jordan Fuzi
- Department of Otolaryngology/Head and Neck Surgery, Prince of Wales Hospital, Randwick, Australia
- Faculty of Medicine, University of Sydney, Camperdown, Australia
| | - Catherine Meller
- Department of Otolaryngology/Head and Neck Surgery, Prince of Wales Hospital, Randwick, Australia
| | - Sydney Ch'ng
- Faculty of Medicine, University of Sydney, Camperdown, Australia
- Department of Plastic and Reconstructive Surgery, Chris O'Brien Lifehouse, Camperdown, Australia
| | - Joseph Dusseldorp
- Faculty of Medicine, University of Sydney, Camperdown, Australia
- Department of Plastic and Reconstructive Surgery, Chris O'Brien Lifehouse, Camperdown, Australia
- Department of Plastic and Reconstructive Surgery, Concord Repatriation General Hospital, Concord, Australia
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Pham TB, Greene JJ. Reducing Risk in Facial Reanimation Surgery. Facial Plast Surg Clin North Am 2023; 31:297-305. [PMID: 37001932 DOI: 10.1016/j.fsc.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Facial reanimation surgery can greatly improve quality of life, but these procedures are not without risk. Important considerations for risk reduction in facial reanimation surgery include preoperative risk-stratification, protecting patients' clinical media, clearly and thoroughly setting expectations, and intraoperative strategies to maximize technical success and minimize operative time.
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Affiliation(s)
- Tammy B Pham
- Department of Otolaryngology-Head and Neck Surgery, University of California San Diego Health, 9350 Campus Point Drive, La Jolla, CA 92037, USA
| | - Jacqueline J Greene
- Department of Otolaryngology-Head and Neck Surgery, University of California San Diego Health, 9350 Campus Point Drive, La Jolla, CA 92037, USA.
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Hasmat S, Low THH, Dusseldorp JR, Mukherjee P, Clark JR. Facial nerve palsy: Narrative review on the importance of the eye and its assessment. Head Neck 2022; 44:2600-2607. [PMID: 35894515 DOI: 10.1002/hed.27151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/25/2022] [Accepted: 07/07/2022] [Indexed: 11/12/2022] Open
Abstract
New solutions are emerging that address specific facial regions in facial nerve palsy (FNP). However the most dreaded consequence of FNP is paralytic lagophthalmos threatening the eye. A way to prioritize these regions is thus required. A review of the literature is conduced to capture the current concepts in evaluating FNP. Overall, patients are assessed from three perspectives: from the clinician's perspective using validated clinician-based grading instruments, from patient's perspective based on FNP-specific patient-reported outcome measures, and from the perspective of the layperson. The existing tools however provide limited information regarding the relative importance of different regions of the face. The eye appears to be an area of great concern for the patient where most surgical therapies are directed at. Addressing ocular problems in FNP carry a high priority but this is not clearly reflected by the standard systems.
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Affiliation(s)
- Shaheen Hasmat
- Faculty of Medicine, University of Sydney, Camperdown, New South Wales, Australia.,Sydney Facial Nerve Service, The Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Tsu-Hui Hubert Low
- Faculty of Medicine, University of Sydney, Camperdown, New South Wales, Australia.,Sydney Facial Nerve Service, The Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Joseph R Dusseldorp
- Faculty of Medicine, University of Sydney, Camperdown, New South Wales, Australia.,Sydney Facial Nerve Service, The Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Payal Mukherjee
- Faculty of Medicine, University of Sydney, Camperdown, New South Wales, Australia.,Sydney Facial Nerve Service, The Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Jonathan R Clark
- Faculty of Medicine, University of Sydney, Camperdown, New South Wales, Australia.,Sydney Facial Nerve Service, The Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
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