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Schuhmann L, Büchner T, Heinrich M, Volk GF, Denzler J, Guntinas-Lichius O. Automated analysis of spontaneous eye blinking in patients with acute facial palsy or facial synkinesis. Sci Rep 2024; 14:17726. [PMID: 39085410 PMCID: PMC11292012 DOI: 10.1038/s41598-024-68707-x] [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: 02/14/2024] [Accepted: 07/26/2024] [Indexed: 08/02/2024] Open
Abstract
Although patients with facial palsy often complain of disturbed eye blinking which may lead to visual impairment, a blinking analysis is not part of routine grading of facial palsy. Twenty minutes of spontaneous eye blinking at rest of 30 patients with facial palsy (6 with acute palsy; 24 patients with facial synkinesis; median age: 58 years, 67% female), and 30 matched healthy probands (median age: 57 years; 67% female) was smart phone video recorded. A custom computer program automatically extracted eye measures and determined the eye closure rate (eye aspect ratio [EAR]), blink frequency, and blink duration. Facial Clinimetric Evaluation (FaCE), Facial Disability Index (FDI) were assessed as patient-reported outcome measures. The minimal EAR, i.e., minimal visible eye surface during blinking, was significantly higher on the paretic side in patients with acute facial palsy than in patients with synkinesis or in healthy controls. The blinking frequency on the affected side was significantly lower in both patient groups compared to healthy controls. Vice versa, blink duration was longer in both patient groups. There was no clear correlation between the blinking values and FaCE and FDI. Blinking parameters are easy to estimate automatically and add a functionally important parameter to facial grading.
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Affiliation(s)
- Lukas Schuhmann
- Department of Otorhinolaryngology, Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Tim Büchner
- Computer Vision Group, Friedrich Schiller University Jena, Jena, Germany
| | - Martin Heinrich
- Department of Otorhinolaryngology, Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany
- Facial-Nerve-Center Jena, Jena University Hospital, Jena, Germany
- Center for Rare Diseases, Jena University Hospital, Jena, Germany
| | - Gerd Fabian Volk
- Department of Otorhinolaryngology, Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany
- Facial-Nerve-Center Jena, Jena University Hospital, Jena, Germany
- Center for Rare Diseases, Jena University Hospital, Jena, Germany
| | - Joachim Denzler
- Computer Vision Group, Friedrich Schiller University Jena, Jena, Germany
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany.
- Facial-Nerve-Center Jena, Jena University Hospital, Jena, Germany.
- Center for Rare Diseases, Jena University Hospital, Jena, Germany.
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Ballmaier J, Hölzer S, Geitner M, Kuttenreich AM, Erfurth C, Guntinas-Lichius O, Volk GF. [Telemedicine for patients with facial palsy : Current developments and options in otorhinolaryngologic treatment]. HNO 2024:10.1007/s00106-024-01449-4. [PMID: 38530382 DOI: 10.1007/s00106-024-01449-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 03/28/2024]
Abstract
Digitalization is also becoming increasingly important in medicine. The COVID-19 pandemic has further accelerated this process and politicians are trying to create a framework for successful knowledge transfer and better digital medical care. This article describes the role of telemedicine in the treatment of patients suffering from facial nerve palsy. Facial nerve palsy has a wide range of effects, from limitations in facial mobility to psychological sequelae. While many of the acute, idiopathic facial nerve palsies improve after a few weeks, around a third of those affected develop synkinesis, involuntary movements that have lifelong functional and psychological consequences. Treatment includes various modalities, from medication and surgery to movement training. Telemedicine offers innovative solutions in cases of regional underuse, but also in the treatment of chronic facial nerve palsies. The article defines the term "telemedicine" in the current context and presents different types of application. A detailed analysis of the application scenarios of telemedicine in facial nerve palsy patients shows that despite a lack of evidence, many potentially useful concepts exist.
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Affiliation(s)
- Jonas Ballmaier
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Institut für Phoniatrie und Pädaudiologie, Universitätsklinikum Jena, Jena, Deutschland
- Fazialis-Nerv-Zentrums Jena, Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Institut für Phoniatrie und Pädaudiologie, Universitätsklinikum Jena, Haus A, Am Klinikum 1, 07747, Jena, Deutschland
- Zentrum für Seltene Erkrankungen Jena, Universitätsklinik Jena, Jena, Deutschland
| | - Sabrina Hölzer
- Fachbereich Wirtschaftsingenieurswesen, Ernst-Abbe-Hochschule Jena, Jena, Deutschland
| | - Maren Geitner
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Institut für Phoniatrie und Pädaudiologie, Universitätsklinikum Jena, Jena, Deutschland
- Fazialis-Nerv-Zentrums Jena, Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Institut für Phoniatrie und Pädaudiologie, Universitätsklinikum Jena, Haus A, Am Klinikum 1, 07747, Jena, Deutschland
- Zentrum für Seltene Erkrankungen Jena, Universitätsklinik Jena, Jena, Deutschland
| | - Anna-Maria Kuttenreich
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Institut für Phoniatrie und Pädaudiologie, Universitätsklinikum Jena, Jena, Deutschland
- Fazialis-Nerv-Zentrums Jena, Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Institut für Phoniatrie und Pädaudiologie, Universitätsklinikum Jena, Haus A, Am Klinikum 1, 07747, Jena, Deutschland
- Zentrum für Seltene Erkrankungen Jena, Universitätsklinik Jena, Jena, Deutschland
| | - Christian Erfurth
- Fachbereich Wirtschaftsingenieurswesen, Ernst-Abbe-Hochschule Jena, Jena, Deutschland
| | - Orlando Guntinas-Lichius
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Institut für Phoniatrie und Pädaudiologie, Universitätsklinikum Jena, Jena, Deutschland
- Fazialis-Nerv-Zentrums Jena, Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Institut für Phoniatrie und Pädaudiologie, Universitätsklinikum Jena, Haus A, Am Klinikum 1, 07747, Jena, Deutschland
- Zentrum für Seltene Erkrankungen Jena, Universitätsklinik Jena, Jena, Deutschland
| | - Gerd Fabian Volk
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Institut für Phoniatrie und Pädaudiologie, Universitätsklinikum Jena, Jena, Deutschland.
- Fazialis-Nerv-Zentrums Jena, Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Institut für Phoniatrie und Pädaudiologie, Universitätsklinikum Jena, Haus A, Am Klinikum 1, 07747, Jena, Deutschland.
- Zentrum für Seltene Erkrankungen Jena, Universitätsklinik Jena, Jena, Deutschland.
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Vielsmeier V, Hackenberg S, Schelzig H, Knapsis A. [Update on neck trauma]. HNO 2022; 70:724-735. [PMID: 36066623 DOI: 10.1007/s00106-022-01214-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Important organs and structures are located in the cervical region. In case of blunt and penetrating trauma, emergency situations may arise. OBJECTIVE Emergency management as well as diagnostic and therapeutic steps pertaining to neck injuries are presented. CONCLUSION Shock therapy and airway management are essential, fast management of neck injuries highly relevant.
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Affiliation(s)
- V Vielsmeier
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Regensburg, Regensburg, Deutschland.
| | - S Hackenberg
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - H Schelzig
- Klinik für Gefäß- und Endovaskularchirurgie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - A Knapsis
- Klinik für Gefäß- und Endovaskularchirurgie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
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Facial Emotion Recognition in Patients with Post-Paralytic Facial Synkinesis—A Present Competence. Diagnostics (Basel) 2022; 12:diagnostics12051138. [PMID: 35626294 PMCID: PMC9139660 DOI: 10.3390/diagnostics12051138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 04/28/2022] [Accepted: 04/28/2022] [Indexed: 11/17/2022] Open
Abstract
Facial palsy is a movement disorder with impacts on verbal and nonverbal communication. The aim of this study is to investigate the effects of post-paralytic facial synkinesis on facial emotion recognition. In a prospective cross-sectional study, we compared facial emotion recognition between n = 30 patients with post-paralytic facial synkinesis (mean disease time: 1581 ± 1237 days) and n = 30 healthy controls matched in sex, age, and education level. Facial emotion recognition was measured by the Myfacetraining Program. As an intra-individual control condition, auditory emotion recognition was assessed via Montreal Affective Voices. Moreover, self-assessed emotion recognition was studied with questionnaires. In facial as well as auditory emotion recognition, on average, there was no significant difference between patients and healthy controls. The outcomes of the measurements as well as the self-reports were comparable between patients and healthy controls. In contrast to previous studies in patients with peripheral and central facial palsy, these results indicate unimpaired ability for facial emotion recognition. Only in single patients with pronounced facial asymmetry and severe facial synkinesis was an impaired facial and auditory emotion recognition detected. Further studies should compare emotion recognition in patients with pronounced facial asymmetry in acute and chronic peripheral paralysis and central and peripheral facial palsy.
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