Function and Form Outcomes in Patients With Facial Paralysis
Condition: Facial Paralysis; Bell Palsy
MeSH terms: Bell Palsy; Facial Paralysis; Paralysis; Facies
Study type: Observational

Summary: 
      This study will be unique for the rehabilitation of patients with facial paralysis in that
      the focus is to generate novel 3D facial soft tissue measures to characterize the condition
      and temporal changes, and on the generation of future testable hypotheses to optimize
      surgical interventions and outcomes. In addition, the investigators will extend our previous
      work, beyond the facial circumoral and lip areas/zones, to characterize additional facial
      zones specific for facial paralysis.

      The approach for facial mapping of soft tissue movement, when validated through this proposed
      study, can be used for both surgical planning and to support the development and training of
      implantable facial pacing devices. Mapping both normal facial movements and movements of
      patients with unilateral facial paralysis are vital to describe the temporal and spatial
      course of the recovery process. Ultimately, this information can be used to inform clinicians
      on the precise placement of these devices and the signal strength needed to facilitate
      movements in the required 'paralyzed' facial zones until the recovery process has been
      completed.
    

Detailed description: 
      Patients with facial paralysis have an obvious facial disability. The resultant facial
      disability includes facial disfigurement and impairment in soft tissue movements,
      particularly in facial expressive behaviors. These negative physical sequelae not only impact
      facial esthetics and function, but also patients' social and emotional quality of life.
      Treatments range from non-surgical interventions and facial reanimation surgery to new
      implantable facial pacing devices that would potentially initiate artificial movement on the
      paralyzed side of the face. Traditionally, surgeons' plan treatment based on isolated
      measurements made from 2D photographs and subjective grading of the patient's face, both of
      which are limited in scope and dimension. Our research group has demonstrated the utility of
      a novel 3D dynamic and static quantitative (objective) measures for the evaluation of facial
      soft tissue function. The measures are objective and quantitative, and they provide a more
      precise diagnosis of facial soft tissue disability and evaluation of surgical outcomes. The
      main goal of this prospective, observational study is to determine the applicability of these
      novel 3D dynamic and static measures for quantification and measurement of impairment and
      disfigurement, as well as change over time, in patients with facial paralysis. The global
      hypothesis is that the use of the measures will provide a more comprehensive analysis of the
      severity of facial paralysis and the changes over time (recovery) when compared with current
      assessment methods.
    

Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        The subjects for this study will be adults 18 to 75 years. The subjects who are potentially
        eligible for participation will be identified through the participating Centers: For the
        patients with facial paralysis through the Facial Nerve Center (FNC) at Massachusetts Eye
        and Ear Infirmary (MEEI); and for the control subjects through Tufts University School of
        Dental Medicine (TUSDM). Subjects recruited from MEEI will attend TUSDM for testing where
        Dr. Trotman maintains her Facial Animation laboratory. The participating surgeon is Dr.
        Tessa Hadlock and she will be responsible for the clinical care of all patients.
      
Keywords: Facial Paralysis; Bell's Palsy; unilateral; 3D; 3D imaging; Facial form; Facial function