Abstract

BackgroundFacial palsy or paralysis (FP) is a symptom that loses voluntary muscles movement in one side of the human face, which could be very devastating in the part of the patients. Traditional methods are solely dependent to clinician’s judgment and therefore time consuming and subjective in nature. Hence, a quantitative assessment system becomes apparently invaluable for physicians to begin the rehabilitation process; and to produce a reliable and robust method is challenging and still underway.MethodsWe introduce a novel approach for a quantitative assessment of facial paralysis that tackles classification problem for FP type and degree of severity. Specifically, a novel method of quantitative assessment is presented: an algorithm that extracts the human iris and detects facial landmarks; and a hybrid approach combining the rule-based and machine learning algorithm to analyze and prognosticate facial paralysis using the captured images. A method combining the optimized Daugman’s algorithm and Localized Active Contour (LAC) model is proposed to efficiently extract the iris and facial landmark or key points. To improve the performance of LAC, appropriate parameters of initial evolving curve for facial features’ segmentation are automatically selected. The symmetry score is measured by the ratio between features extracted from the two sides of the face. Hybrid classifiers (i.e. rule-based with regularized logistic regression) were employed for discriminating healthy and unhealthy subjects, FP type classification, and for facial paralysis grading based on House-Brackmann (H-B) scale.ResultsQuantitative analysis was performed to evaluate the performance of the proposed approach. Experiments show that the proposed method demonstrates its efficiency.ConclusionsFacial movement feature extraction on facial images based on iris segmentation and LAC-based key point detection along with a hybrid classifier provides a more efficient way of addressing classification problem on facial palsy type and degree of severity. Combining iris segmentation and key point-based method has several merits that are essential for our real application. Aside from the facial key points, iris segmentation provides significant contribution as it describes the changes of the iris exposure while performing some facial expressions. It reveals the significant difference between the healthy side and the severe palsy side when raising eyebrows with both eyes directed upward, and can model the typical changes in the iris region.

Highlights

  • Facial palsy or paralysis (FP) is a symptom that loses voluntary muscles movement in one side of the human face, which could be very devastating in the part of the patients

  • Peripheral facial palsy is the result of a nerve dysfunction in the pons of the brainstem where the upper, middle and lower one side of facial muscles are affected while central facial palsy is the result of nerve function disturbances in the cortical areas where the lower half of one side of the face is affected but the forehead and eyes are spared, unlike in peripheral FP (Fig. 1) [1, 2]

  • In our experiments, 325 facial images were taken from 65 subjects that include 50 patients and 15 healthy subjects. 50 patients consist of 29 males and 21 females, whereas, healthy subjects contains 5 males and 10 females

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Summary

Introduction

Facial palsy or paralysis (FP) is a symptom that loses voluntary muscles movement in one side of the human face, which could be very devastating in the part of the patients. It often causes patients to be introverted and eventually suffer from social and psychological distress, which can be even more severe than the physical disability [3]. This scenario has led to greater interest to researchers and to clinicians in this field, and to the development of grading facial functions and methods in monitoring the effect of medical, rehabilitation or surgical treatment

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