Facial Disorders Research Articles

Facial Nerve Disorders: Sociodemographic Predictors and Temporal Trends in Dynamic Facial Reanimation in a National Administrative Claims Database.

Background: Recent surgical innovations have increased treatment options for patients with facial nerve disorders (FNDs), leading to substantial improvements in functional and psychosocial outcomes. However, it is unclear whether sociodemographic factors are associated with the likelihood of undergoing dynamic facial reanimation procedures. Objective: In patients undergoing FND surgical treatment, what sociodemographic variables are associated with undergoing dynamic facial reanimation compared with static facial reanimation within a 16-year period? Methods: This was a retrospective study of adults undergoing surgical management for FND from 2007 to 2022 using the Merative™ Marketscan® Research Databases. Chi-squared and logistic regression analyses were performed. Results: Among 4,730 adults who underwent FND surgical intervention, 1,390 (34.2%) underwent dynamic facial reanimation. In multivariable regression analyses, more recent treatment year, younger age, and living in the Northeast United States were significant predictors of undergoing dynamic reanimation. Secondary analysis demonstrated that FND patients who were younger, female, and living in the Northeast United States were more likely to undergo concurrent selective neurectomy. Conclusions: These analyses demonstrate significant sociodemographic and temporal associations in the surgical management of FND. Future work is needed to evaluate how sociodemographic factors might influence access and decisions to pursue different types of reanimation procedures.

Clinical Efficacy Analysis of Acupuncture Treatment in the Acute Phase of Peripheral Facial Paralysis

Peripheral facial paralysis, caused by damage to the lower motor neurons of the facial nerve, is a neurological disorder characterized by partial or complete loss of facial expression. It typically manifests suddenly with symptoms such as post-auricular pain, diminished taste, excessive tearing, difficulty speaking, and facial muscle twitching. Depending on the underlying cause, this condition can be categorized into spontaneous facial nerve palsy, peripheral facial paralysis induced by Guillain-Barré syndrome, and peripheral facial paralysis caused by brainstem lesions. Among these, the most common type is Bell’s palsy, which usually presents as sudden unilateral facial muscle paralysis. The incidence rate is approximately 20 to 40 cases per 100,000 people annually, with patients ranging in age from young to old, although it is most prevalent in those aged 20 to 40, and it tends to occur more frequently in men than in women. Conventional treatments for peripheral facial nerve paralysis include hormone therapy, antiviral medication, and surgical intervention. However, hormone therapy may not be effective for some patients due to its side effects, the efficacy of antiviral therapy remains controversial, and surgery is costly and may lead to postoperative complications. Traditional Chinese Medicine (TCM) acupuncture therapy, with a long-standing history, has been widely used to treat such facial nerve disorders as documented in the "Huangdi Neijing · Suwen."

Comparing the Differences in Adverse Events among Chimeric Antigen Receptor T-Cell Therapies: A Real-World Pharmacovigilance Study.

In this study, we compared the similarities and differences in adverse events (AEs) among CAR T-cell products through signal mining via the FDA Adverse Event Reporting System (FAERS) and identified unknown AEs to provide a reference for safe clinical medication. Data from the FAERS database spanning from the fourth quarter of 2017 to the first quarter of 2024 were extracted. Signals were identified using the reporting odds ratio (ROR) method and the Medicines and Healthcare Products Regulatory Agency (MHRA) method. A total of 11,386 AE reports related to six CAR T-cell products were selected. The top three categories of AEs reported were nervous system disorders, immune system disorders, and general disorders and administration site conditions. However, there were variations in the AE spectra among the different CAR T-cell products. The BCMA-targeting drugs idecabtagene vicleucel (Ide-cel) and ciltacabtagene autoleucel (Cilta-cel) were found to be associated with parkinsonism, which were not observed in CD19-targeting drugs. Tisagenlecleucel (Tisa-cel) and axicabtagene ciloleucel (Axi-cel) exhibited cerebrovascular accident-related AEs, graft versus host disease, and abnormal coagulation indices. Cilta-cel was associated with cerebral hemorrhage, intracranial hemorrhage, cranial nerve disorder, and facial nerve disorder. Cardiopulmonary toxicity, including hypoxia, tachypnoea, cardiorenal syndrome, and hypotension, exhibited strong signal intensities and considerable overlap with CRS. The number of positive signals for cardiopulmonary toxicity associated with drugs targeting CD-19 is greater. Clinicians should assess patients prior to medication and closely monitor their vital signs, mental status, and laboratory parameters during treatment.

A study of facial nerve palsy in a tertiary care hospital in south Rajasthan - A cross sectional observational study

Introduction Face is the interpreter of emotions, mirror of soul, powerhouse of senses and wayfor communication. Facial nerve is the seventh cranial nerve which serves vital functions of lacrimation, salivation, taste, hearing and facial expression. It necessitates urgent measures to understand the cause and nature of nerve injury and undertake immediate steps for restoration and rehabilitation of facial symmetry. About 90% of lower motor neuron facial nerve disorders- inflammatory, traumatic or neoplastic, happens along its intratemporal course. Over past two decades, many developments have been made. Newer technologies like radiology, electrodiagnostic study and emergence of intraoperative monitoring have been helpful. Complex course within the bony canal, congenital dehiscence, fine branching, interconnections, segmental blood supply, all these factors show significantly, heading towards causation and final result of insult to nerve. A list of etiologies commonly Bell's palsy, followed by Temporal bone fracture, Iatrogenic trauma, Herpes Zoster Oticus, Otitis Media (OM), Cerebellopontine (CP) angle or Intratemporal neoplasm (facial nerve Schwannoma), result in facial nerve paralysis. The nerve testing depends on determining the scale of distal axonal degeneration (electrodiagnosis), function of branches of the nerve (topo diagnosis) and radiologic guidance in indicated cases1. The pathways of the facial nerve are variable, and knowledge of the key intratemporal and extratemporal landmarks is essential for accurate physical diagnosis and safe and effective surgical intervention.

Computer-vision analysis of craniofacial dysmorphology in 22q11.2 deletion syndrome and psychosis spectrum disorders

BackgroundMinor physical anomalies (MPAs) are congenital morphological abnormalities linked to disruptions of fetal development. MPAs are common in 22q11.2 deletion syndrome (22q11DS) and psychosis spectrum disorders (PS) and likely represent a disruption of early embryologic development that may help identify overlapping mechanisms linked to psychosis in these disorders.MethodsHere, 2D digital photographs were collected from 22q11DS (n = 150), PS (n = 55), and typically developing (TD; n = 93) individuals. Photographs were analyzed using two computer-vision techniques: (1) DeepGestalt algorithm (Face2Gene (F2G)) technology to identify the presence of genetically mediated facial disorders, and (2) Emotrics—a semi-automated machine learning technique that localizes and measures facial features.ResultsF2G reliably identified patients with 22q11DS; faces of PS patients were matched to several genetic conditions including FragileX and 22q11DS. PCA-derived factor loadings of all F2G scores indicated unique and overlapping facial patterns that were related to both 22q11DS and PS. Regional facial measurements of the eyes and nose were smaller in 22q11DS as compared to TD, while PS showed intermediate measurements.ConclusionsThe extent to which craniofacial dysmorphology 22q11DS and PS overlapping and evident before the impairment or distress of sub-psychotic symptoms may allow us to identify at-risk youths more reliably and at an earlier stage of development.

A phase II trial combining SHR-1316, bevacizumab, and cisplatin/carboplatin in patients with TNBC with active brain metastases.

e13133 Background: Triple-negative breast cancer (TNBC) has a high risk of brain metastases (BM), leading to poor survival. Treatment options for BMs are limited, and the combination of chemotherapy and immune checkpoint inhibitor is the standard-of-care for PD-L1 positive metastatic TNBC. Platinum-based systematic therapy is the mainstay of TNBC treatment and the addition of bevacizumab has shown improvement in the progression-free survival (PFS) of patients with BM. Therefore, this study aims to investigate the efficacy and safety of SHR-1316 (anti-PD-L1) in combination with bevacizumab and cisplatin/carboplatin in TNBC patients with BMs. Methods: In this single-center phase II trial, TNBC patients with active BM received SHR-1316, bevacizumab, and cisplatin/carboplatin. Prior treatment with bevacizumab or anti-PD-1/PD-L1 were not allowed. Prior platinum was allowed only in cases of previous platinum-sensitive response. The primary endpoint was objective response rate (ORR) of central nervous system (CNS), as assessed according to the response assessment in neuro-oncology brain metastases. The secondary endpoint included clinical benefit rate (CBR) of CNS, PFS, overall survival (OS), first progression site and safety. Results: As of January 12th, 2024, a total of 23 female patients with ECOG PS≥1(100%) were enrolled. The median number of previous lines of therapy for metastatic disease was 1 (0-3). All patients had active BM, of which 87% (20/23) were BM treatment-naïve and 13% (3/23) had BM progression after previous local therapy, 26.1% (6/23) had received a prior platinum agent. Of the 23 evaluable patients, the confirmed CNS ORR was 65.2% (95%CI: 42.7%-83.6%), with 3 complete response (CR), 12 partial response (PR), 7 stable disease (SD), and 1 progressive disease (PD). The median CNS-PFS was 11.2 months (95%CI, 5.8 to not reached), median PFS was 7.6 months (95%CI, 5.7-11.9), and median OS was 13.2 months (95%CI, 9.5 to not reached). Treatment-related adverse events (TRAEs) were reported in all 23 patients, and the most common TRAEs were neutrophil count decreased (69.6%, 16/23), anemia (65.2%, 15/23), asthenia (60.9%, 14/23), Hypomagnesaemia (56.5%, 13/23), leukopenia (52.2%, 12/23) and electrocardiogram T wave abnormal (52.2%, 12/23). The incidence of grade ≥3 TRAEs was 43.5% (10/23), including neutropenia (13%, 3/23), platelet count decreased (8.7%, 2/23), and hypertension (8.7%, 2/23). Only one patient had a grade 4 TRAE (lymphocytopenia), and SHR-1316 related serious adverse event (facial nerve disorder) occurred in only one patient. No grade 5 AEs were noted. Conclusions: SHR-1316 plus bevacizumab and cisplatin/carboplatin achieves a significant improvement in CNS ORR and brings PFS and OS benefits in TNBC patients with active BMs. As an effective and safe treatment, this triple-combination warrants further investigation. Clinical trial information: NCT04303988 .

Management of facial nerve trauma.

To present the current literature on management of facial nerve disorder secondary to trauma, with a focus on the utility of electrodiagnostic testing in this setting. Patients with facial palsy related to temporal bone fractures should be started on high-dose corticosteroids as early as possible. Recent literature on the benefit of surgical intervention in the setting of temporal bone fracture is mixed. Some studies support early surgical decompression whereas others have found no benefit compared with conservative treatment. The management of facial nerve trauma is based on location and extent of injury. Extratemporal trauma and transected nerve should be treated with surgical exploration and tension-free coaptation ideally within 72 h. There are no guidelines for intratemporal facial nerve trauma. Surgical decompression compared with medical management is debated in the literature without consensus and more large studies are needed.

Correlation of 3D Morphometric Changes, Kinematics, and Muscle Activity During Smile.

Knowing the morphological, kinematic, and electrophysiological parameters of the smile in healthy individuals may contribute to evaluating, planning, and monitoring the smile reanimation. This study aimed to determine the correlation between 3D morphometric changes, movement kinematics, and muscle activity in the facial soft tissue of healthy individuals. In this cohort study, 20 volunteers were selected from healthy individuals with no facial disorders. During smiling, three-dimensional face scanning, facial motion capture, and surface electromyography (sEMG) were performed. The average displacement, velocity, and acceleration during facial movements were measured. The mean change in 3D surface morphometry and activation of the zygomaticus major were determined. The volunteers, comprising 10 males and 10 females, had a mean age of 24 ± 10 years; for female, mean age was 23 ± 5 years and for men 26 ± 13 years. Significant correlations were found between kinematic and morphometric data (r = 0.51, p < 0.001), sEMG and morphometric (r = 0.50, p < 0.001) data, and sEMG and kinematic data (r = 0.49, p < 0.002). The maximum acceleration occurred during approximately 65% of the muscle activation time and 64% of the peak muscle activation value. Additionally, the maximum velocity was reached at around 73% of the muscle activation time and 67% of the peak muscle activation value. Furthermore, the maximum displacement values were observed at approximately 88% of the muscle activation time and 76% of the peak muscle activation value. The findings may provide insights into the smile's functional parameters, contribute to understanding facial muscle-related disorders, and aid in improving the diagnosis and treatment of the smile. NA Laryngoscope, 134:3112-3119, 2024.

Botulinum therapy for facial nerve disorders in Russia

Botulinum toxin type A (BTA) has taken a strong place in the rehabilitation of patients with impaired function of mimic muscles in both acute and late post-paralytic periods.Aim: to highlight the main stages of the development of botulinum therapy (BT) in the treatment of mimic muscles dysfunctions in Russia.Methods. Published data were searched in the electronic database Medline (PubMed) and eLibrary.Results. The role of BT in the treatment of mimic muscles dysfunctions, synkinesis (which can be interpreted clinically as secondary hemifacial spasm), lacrimation, dry eye syndrome, as well as the role of BT in the formation of protective ptosis, was analyzed. The stages of the BT formation in Russia as a method of restoring the function of mimic muscles by specialists of various profiles (neurologists, maxillofacial surgeons, rehabilitation specialists, etc.) are described.Conclusion. Currently, there is a BT school in Russia, which based on extensive clinical experience, developed algorithms and methods for administering BT to patients with facial nerve disorders of various etiologies.

Analysis of the association between vestibular schwannoma and hearing status using a newly developed radiomics technique.

Vestibular schwannoma is a benign tumor originating from Schwann cells surrounding the eighth cranial nerve and can cause hearing loss, tinnitus, balance problems, and facial nerve disorders. Because of the slow growth of the tumor, predicting the hearing function of patients with vestibular schwannoma's is important to obtain information that would be useful for deciding the treatment modality. This study aimed to analyze the association between magnetic resonance imaging features and hearing status using a new radiomics technique. We retrospectively analyzed 115 magnetic resonance images and hearing results from 73 patients with vestibular schwannoma. A total of 70 radiomics features from each tumor volume were calculated using T1-weighted magnetic resonance imaging. Radiomics features were classified as histogram-based, shape-based, texture-based, and filter-based. The least absolute shrinkage and selection operator method was used to select the radiomics features among the 70 features that best predicted the hearing test. To ensure the stability of the selected features, the least absolute shrinkage and selection operator method was repeated 10 times. Finally, features set five or more times were selected as radiomics signatures. The radiomics signatures selected using the least absolute shrinkage and selection operator method were: minimum, variance, maximum 3D diameter, size zone variance, log skewness, skewness slope, and kurtosis slope. In random forest, the mean performance was 0.66 (0.63-0.77), and the most important feature was Log skewness. Newly developed radiomics features are associated with hearing status in patients with vestibular schwannoma and could provide information when deciding the treatment modality.

Clinical analysis of lupus miliaris disseminatus faciei: a cross-sectional study and literature review.

The clinical similarity of lupus miliaris disseminatus faciei (LMDF) and other papular granulomatous facial disorders often makes its correct diagnosis challenging. Diagnosis often requires the assistance of pathological examination, and dermoscopy can be used as an auxiliary and non-invasive examination method, however, the current findings remain incomplete. This study aimed to summarize the clinical, histopathological and dermoscopic features of LMDF in the Chinese Han population and aiming to provide practical significance to correct diagnosis. 109 patients of LMDF were collected in the Department of Dermatology, the Second Affiliated Hospital of Xi'an Jiaotong University from August 2015 to August 2023. The clinical and histopathological manifestations of all patients, as well as the dermoscopic image features of 44 cases, including background, follicular findings, vessels, and other structures, were summarized and evaluated. The most significant histopathological features of LMDF in 109 cases is epithelioid granulomatous infiltrate in the superficial dermis, with or without caseation. The most significant dermoscopic features of LMDF in all 44 cases were orange structureless background (30/44), follicular plug (32/44), follicular white scar-like area (32/44), unspecific linear vessels (24/44), linear vessels with branch (24/44) and white streaks (18/44). Histopathologically, LMDF is characterized by the presence of epithelioid granulomatous infiltrate in the superficial dermis, with or without caseation. Dermoscopically, it exhibits a distinctive orange structureless background, follicular plug, follicular white scar-like area, nonspecific linear vessels, linear vessels with branches, and white streaks.

The potential of electromyography, diagnostic transcranial magnetic stimulation, and multiparametric magnetic resonance imaging in the combinatory assessment of facial nerve disorders: a literature review and clinical case series

Facial neuropathy (FN) is a complex multicausal problem that, with a seemingly obvious clinical picture, might be challenging to diagnose. Up to 5% of FN cases could be caused by neoplastic or otogenic processes, necessitating an interdisciplinary approach to its treatment by various specialties and in some cases a surgical intervention. In addition, in the early stages of FN, it is difficult to predict its outcomes. Therefore, beyond usual neurological exam and widely used electromyography (EMG), other additional diagnostic tools are used to ensure extended diagnosis, including cancer awareness.&#x0D; In this paper we have analyzed the principles, role and value of computed tomography, magnetic resonance imaging (MRI), diagnostic transcranial magnetic stimulation combined with EMG, and ultrasound assessment with a high-frequency linear transducer in acute FN. We present our own clinical cases of pediatric patients with FN, who were assessed with EMG and multiparametric MRI including diffusion tensor imaging. These cases illustrate both the abnormalities found in the typical course of Bell's palsy, as well as the abnormalities in neoplasm-associated FN that clinically fully mimic the Bell's palsy. Based on the world experience in multiparametric MRI, including the use of extended protocols in the Pediatric Research and Clinical Center for Infectious Diseases, in case of suspected FN, the most important are high-resolution structural submillimeter sequences based on the gradient echo (SSFP) and diffusion tensor imaging (DTI). Measurement and assessment of fractional anisotropy at the motor nuclei of the facial nerves in the pons look promising for further research. The paper is the first to describe a modified combination diagnostic approach to Bell's palsy with the use of diagnostic transcranial magnetic stimulation with round coil, supramaximal stimulation with identification of the motor evoked response threshold (minimal inducer power to register a reproducible evoked motor response of 50-100 mV in amplitude) in the occipito-parietal area of the ipsilateral muscle.

Bilirubin Nanomedicine Alleviates Inflammation and Angiogenesis in a Rosacea Mouse Model

AbstractRosacea is a common chronic inflammatory facial disorder. Reactive oxygen species (ROS) have a key role in the pathogenesis of rosacea. In this study, the antioxidant and anti‐inflammatory effects of bilirubin‐based nanoparticles (BRNPs) are investigated in the LL‐37‐induced rosacea‐like mouse model. Effects of BRNPs on rosacea‐like skin inflammation and ROS level of the skin are determined using histological analysis. The expression of genes encoding rosacea‐associated cytokines and chemokines is assessed and the molecular mechanisms of BRNPs against rosacea are investigated using RNA sequencing (RNAseq) analysis. This study reveals that BRNPs significantly alleviate LL‐37‐induced inflammatory manifestation in the rosacea mouse model and reduce the expression of proinflammatory cytokines (interleukin [IL]‐1β, IL‐6, and tumor necrosis factor [TNF]‐α) and chemokines (C‐X‐C motif chemokine ligand 8 [CXCL8] and CXCL10). Moreover, BRNPs preferentially localize at the inflammatory skin lesion, decrease the level of ROS in the skin, and ameliorate the vascular endothelial growth factor expression and vascular changes in the skin induced by LL‐37. Furthermore, these findings provide a mechanism for the efficacy of BRNPs in this experimental model and support BRNPs as a potential therapeutic option for rosacea and other related inflammatory skin disorders.

Effects of delay in botulinum toxin treatment on patients with hyperkinetic facial disorders

Objective: Hyperkinetic facial disorders include Benign Essential Blepharospasm (BEB) and Hemifacial Spasm (HFS), which involve involuntary facial muscle contractions. Botulinum toxin (BTX) is essential for relieving symptoms. The Coronavirus-19 (COVID-19) pandemic-related restrictions have led to delays in receiving BTX treatment. This study aims to assess the impact of BTX treatment delays of affected patients. Materials and Methods: This study retrospectively examined the data of 84 patients (68 HFS and 16 BEB) whose BTX appointments were delayed due to COVID-19 restrictions. Patient status was evaluated using Jankovic disability rating scale (JRS) scores, and administered BTX doses were documented and compared before and after lockdown. Results: After the BTX treatment delay, the JRS scores significantly increased from an average of 2.15±0.98 before the lockdown to 3.10±1.01 after the lockdown (p&lt;0.001). Furthermore, there was a noticeable increase in the average BTX treatment dose after the lockdown, from 36.45±1.32 units to 39.25±1.28 units (p&lt;0.001). Conclusion: Longer intervals between injections may increase disease severity and the effective BTX doses in patients with HFS and BEB. The COVID-19 pandemic has highlighted the importance of timely BTX therapy in managing hyperkinetic facial disorders.

Prioritization of non-coding elements involved in non-syndromic cleft lip with/without cleft palate through genome-wide analysis of de novo mutations.

Non-syndromic cleft lip with/without cleft palate (nsCL/P) is a highly heritable facial disorder. To date, systematic investigations of the contribution of rare variants in non-coding regions to nsCL/P etiology are sparse. Here, we re-analyzed available whole-genome sequence (WGS) data from 211 European case-parent trios with nsCL/P and identified 13,522 de novo mutations (DNMs) in nsCL/P cases, 13,055 of which mapped to non-coding regions. We integrated these data with DNMs from a reference cohort, with results of previous genome-wide association studies (GWASs), and functional and epigenetic datasets of relevance to embryonic facial development. A significant enrichment of nsCL/P DNMs was observed at two GWAS risk loci (4q28.1 (p= 8×10-4) and 2p21 (p= 0.02)), suggesting a convergence of both common and rare variants at these loci. We also mapped the DNMs to 810 position weight matrices indicative of transcription factor (TF) binding, and quantified the effect of the allelic changes in silico. This revealed a nominally significant overrepresentation of DNMs (p= 0.037), and a stronger effect on binding strength, for DNMs located in the sequence of the core binding region of the TF Musculin (MSC). Notably, MSC is involved in facial muscle development, together with a set of nsCL/P genes located at GWAS loci. Supported by additional results from single-cell transcriptomic data and molecular binding assays, this suggests that variation in MSC binding sites contributes to nsCL/P etiology. Our study describes a set of approaches that can be applied to increase the added value of WGS data.

Vestibular Schwannoma Hypofractionated Stereotactic Radiation Therapy in Five Fractions

AimTo retrospectively analyse the long-term results of hypofractionated stereotactic radiation therapy (HSRT) applied in five fractions for vestibular schwannomas. Materials and methodsOne hundred and thirty-four patients with vestibular schwannomas underwent medical treatment of HSRT. The median follow-up time interval was 54 months (range 6–121 months). All patients had a prescribed dose of 22 Gy in five fractions to D90. Restaging was carried out by thin-slice contrast-enhanced T1 magnetic resonance imaging. Progression was defined as 2 mm post-treatment tumour enlargement. Progression or death for any reason was counted as an event in progression-free survival rates. Acute toxicity was defined as adverse events occurring within 3 months of HSRT; long-term toxicity was defined as such events occurring after 3 months. ResultsIn 74/128 patients who had >6 months of follow-up (54%), the HSRT resulted in a partial or a complete response. The mean time interval for response in 50% of these was 4 years, whereas in 49 patients (38%) vestibular schwannomas failed to show any response, resulting in stable disease. Five of 128 patients (4%) showed marked progressive vestibular schwannomas after treatment in the first 3 years; two of them received conventionally fractionated radiation therapy. Local control at 3, 5 and 7 years was 96%, 95% and 94%, respectively. Seven were lost to follow-up. The median planning target volume was 2.1 ml (range 0.78–8.66). The 3- and 5-year progression-free survival rates were 95% and 94%, respectively. Seven patients reported a marked deterioration in hearing ability. Post-radiation therapy magnetic resonance imaging showed variability in oedema collection, but no patient suffered from radio-necrosis. Grade 2 temporary facial nerve disorders were observed in 10 patients (8%) 3–6 months after HSRT. ConclusionDelivering HSRT in five fractions for vestibular schwannoma appears safe and efficient, combining both efficiency and short treatment time while optimising neurological function preservation.

Fast 3D Face Reconstruction from a Single Image Using Different Deep Learning Approaches for Facial Palsy Patients.

The 3D reconstruction of an accurate face model is essential for delivering reliable feedback for clinical decision support. Medical imaging and specific depth sensors are accurate but not suitable for an easy-to-use and portable tool. The recent development of deep learning (DL) models opens new challenges for 3D shape reconstruction from a single image. However, the 3D face shape reconstruction of facial palsy patients is still a challenge, and this has not been investigated. The contribution of the present study is to apply these state-of-the-art methods to reconstruct the 3D face shape models of facial palsy patients in natural and mimic postures from one single image. Three different methods (3D Basel Morphable model and two 3D Deep Pre-trained models) were applied to the dataset of two healthy subjects and two facial palsy patients. The reconstructed outcomes were compared to the 3D shapes reconstructed using Kinect-driven and MRI-based information. As a result, the best mean error of the reconstructed face according to the Kinect-driven reconstructed shape is 1.5±1.1&amp;nbsp;mm. The best error range is 1.9±1.4&amp;nbsp;mm when compared to the MRI-based shapes. Before using the procedure to reconstruct the 3D faces of patients with facial palsy or other facial disorders, several ideas for increasing the accuracy of the reconstruction can be discussed based on the results. This present study opens new avenues for the fast reconstruction of the 3D face shapes of facial palsy patients from a single image. As perspectives, the best DL method will be implemented into our computer-aided decision support system for facial disorders.

Facial involvement in multiple sclerosis

BackgroundMultiple sclerosis (MS) can present with facial symptoms and signs, such as facial palsy, myokymia, and hemifacial spasm. Considering the importance of early diagnosis, treatment, and exclusion of causes other than MS, we aimed to assess the prevalence of these disorders in patients with MS. MethodsMS patients who were referred to the Isfahan MS clinic from March 2021 to March 2022 were observed for facial presentations of the disease. A checklist of patients’ baseline characteristics and disease features were then completed through patient interview and medical files. ResultsOf the total of 2260 MS patients who were assessed, 3.27% had facial palsy, 1.28% had myokymia, and 0.84% presented with hemifacial spasm. The mean age of facial symptom onset was 30.74, 29.07, and 31.37 years, respectively. No relationship was found between the type of facial presentation and factors such as age, gender, subtype of MS, affected side of face, and time of presentation. ConclusionOn the grounds that facial disorders can be the first presentation of MS, patients with atypical features of other common facial diseases such as Bell's palsy should therefore be carefully assessed and followed for any clues pertaining to the diagnosis of MS.

Rosacea: An Overview

The National Rosacea Society (NRS) designates April as Rosacea Awareness Month to educate the public on the impact of the chronic and widespread facial disorder that is estimated to affect more than 16 million Americans1. The goal of Rosacea Awareness Month is to spread public education on this disease so that more people who may have rosacea seek medical help before it gets worse, and so those whose lives are affected can find greater public acceptance and understanding.1 Rosacea is a chronic inflammatory skin condition that usually affects the face and fortunately there is a range of medical therapies that may effectively address each individual case2. Through habit, many patients may unknowingly continue with therapy that is not as effective as it could be, when there may be newer medications that achieve more successful results as well as therapy combinations that offer excellent synergistic effects.2

Rare forms of facial neuropathy (historical review)

Discussion of the function of the cranial nerves implies the anatomical features of the nerves, their stem nuclei. In clinical practice, it is important to identify the symptoms of damage to the supranuclear parts of the motor and sensory systems. Following the general pattern that characterizes the location of the fibers, neurological symptoms occur on the same or opposite side. Due to the nature of the passage, signs of involvement of some brain tracts and nuclei of cranial nerves are rarely diagnosed. Aim: to present a description of rare clinical and anatomical variants of facial nerve lesions (according to the literature). Materials and methods. The features of the location of the structures of the cranial nerves’ nuclei and the passage of corticonuclear, pyramidal fibers with the determination of their role in the occurrence of neurological manifestations of mimic muscles dysfunction were analyzed. Results. A detailed study of clinical, neurological symptoms, generalization of anamnesis data and laboratory parameters will allow a practical doctor to diagnose and carry out effective treatment for various types of facial muscle innervation disorders. Conclusion. The features of cranial innervation, in particular, mimic muscles, has important anatomical features. The analysis of the available literature data and the presented results, reflecting the location of the conduction structures and clusters of peripheral motor neurons of the brainstem, allows for a detailed differential diagnosis of damage at different levels.