Corner Of Mouth Research Articles

Applying 3D scanning to evaluate facial symmetry in Asian populations

BackgroundFacial symmetry enhances attractiveness, with various therapies available to improve it. However, trends in facial asymmetry remain unclear. This study evaluates differences between specific facial regions using 3D scanning to guide clinical treatment. MethodThe 3dMD face™ system (3dMD Ltd, USA) scanned 88 subjects' faces. Geomagic Wrap 2021 analyzed the left and right sides. Differences in eyebrow peaks, eyebrow tails, eye ends, and mouth corners were evaluated. ResultsMore subjects showed a drooping right side of the face in eyebrow peaks, eyebrow tails, eye ends, mouth corners, tubercula mentale, and mandibular margin positions. A higher proportion had deeper left nasolabial folds and marionette lines, while more had deeper right tear ducts and lateral chin depressions. More subjects exhibited a prominent right forehead and parotid masseter region, with a prominent left temporal and cheek region. Conclusion3D scanning effectively assesses facial asymmetry in clinical practice. Research indicates significant differences in asymmetry between facial regions. Evaluating these differences pre-treatment can guide the selection of therapeutic methods, improving facial asymmetry treatment. Level of Evidence3 (Diagnostic)

Exploration of acupuncture rehabilitation ideological system for tendon disease in Huangdi Neijing

The jingjin (sinews/fascia) theory of Huangdi Neijing (The Yellow Emperor's Inner Classic) has a profound systematic theoretical structure of the rehabilitation for tendon disease. On the basis of jingjin system, it puts forward the ideological system of acupuncture rehabilitation for tendon disease, in which, "bi" (impediment) is the main syndrome, and "swift insertion of heated needles, the frequency of needling decided by the effects and taking tender sites as acupoints" (referring to diagnosis, acupoint selection and treatment) is the basic principle. It is believed after recognizing the above theory and principle that the tendon disease should be differentiated according to the four seasons and twelve months so as to timely adjust yin and yang. Through analyzing the statement of deviation of the mouth corner (facial paralysis) in Huangdi Neijing, the paper expounds the main symptoms, etiology and pathogenesis, and the effect of treatment for this disease. It is the specific clinical representation of acupuncture rehabilitation ideological system for tendon disease.

Secondary Healing Following Trauma-Induced Partial Glossectomy: Case Report of an Arabian Horse

The tongue serves as an organ of food prehension, mastication, grooming, deglutition, taste, and vocalization, and is suspected to play a role in upper airway stability. A seven-year-old riding horse, weighing 350 kg and employed for load-carrying purposes, was brought to Atatürk University Faculty of Veterinary Medicine Hospital due to a transversal injury in the rostral part of the tongue caused by trauma from the bridle's rope. During the general examination, it was observed that the tongue protruded outside the mouth, there was a presence of necrotic odor, paralysis in the apex lingualis region, and bloodstains on the mouth corner and front limbs. After the removal of the tongue tissue, debridement of the necrotic areas in the remaining caudal portion was performed, and it was left for secondary wound healing. Postoperatively, intramuscular injections of 200,000 IU benzylpenicillin procaine were administered every 24 hours for 7 days, along with flunixin meglumine given for 3 days. Additionally, a 0.12% chlorhexidine gluconate solution was used as an oral antiseptic three times daily for a duration of 7 days. Daily phone calls were made to the patient owner to inquire about the overall condition of the patient. Upon the follow-up appointment on the seventh day, improvement in the healing of the tongue was observed.

Correlation Between Nose-to-Chin Distance and Other Measurements Used to Determine Occlusal Vertical Dimension.

Accurate occlusal vertical dimension (OVD) establishment is an essential component of prosthodontic treatment. No accurate approach exists to determine the appropriate OVD for patients without posterior teeth. This study aimed to correlate the accuracy of the nose-to-chin distance with various facial measurements and thumb length in dentulous and edentulous Saudi patients. The participants comprised 100 fully dentulous Saudi male dental students aged 20-30 years (group 1) and 20 completely edentulous patients aged 60-70 years (group 2). We evaluated the correlations between the OVD (nose-to-chin distance) and the distance from the pupil to the corner of the mouth, the vertical length at midline of the nose (from subnasion to glabella), the distance from the outer canthus of one eye to the inner canthus of the other, twice the distance between the inner canthi, and the distance from the thumb tip to the index fingertip. Spearman's correlation and regression analysis were performed to analyze and assess the correlations between the clinically measured nose-to-chin distance and other parameters, with significance set at 0.05. In edentulous patients, the results showed a significant, strong, positive correlation between the nose-to-chin distance and the distance between the pupil and the mouth corner. In dentate subjects, a significant, strong, positive association was found between the nose-to-chin distance and the distance from the outer canthus of one eye to the inner canthus of the other. The linear regression analysis revealed that the distance between the pupil and the mouth corner in edentulous patients significantly predicted the OVD. In both groups, the distance from the outer canthus of one eye to the inner canthus of the other and the distance from the pupil to the mouth corner were reliable and accurate for OVD measurements. These could be considered appropriate methods for OVD determination during full-mouth rehabilitation.

Redescription of Cyprinion muscatense (Teleostei: Cyprinidae) with the first phylogenetic analysis of the genus.

Members of the genus Cyprinion (Cypriniformes: Cyprinidae) are found in the Indus River basin west to the Arabian Peninsula and the Tigris-Euphrates River drainages (Persian Gulf basin). The taxonomic status of Cyprinion including Cyprinion muscatense is poorly understood when compared to other cyprinid genera. C. muscatense has been considered as a member of the Cyprinion watsoni-microphthalmum group and a valid species endemic to the Arabian Peninsula. Here, we redescribe C. muscatense based on an integrative morphological and molecular approach and freshly sampled material from several localities in the Oman Mountains ecoregion. The results showed that C. muscatense is distinguished from the other Cyprinion species in the Arabian Peninsula by having a short, thin, and slightly serrated last unbranched dorsal fin ray; the lower number of circumpeduncular scales; lateral line scales; and also scales between the lateral line and the dorsal-fin origin. Subterminal mouth, presence of one pair of small barbels at the mouth corner, 3-4 unbranched and 9½-10½ dorsal-fin branched rays, 12-14 pectoral-fin rays, 7-8 pelvic-fin rays, 2-3 unbranched and 6½-7½ branched anal-fin rays, and 37-40 lateral line scales are other morphological characteristics of C. muscatense. C. muscatense is also well distinguished by molecular characters among its congeners. The first molecular phylogenetic analysis of the genus, covering all currently recognized Cyprinion species except for C. watsoni, is also presented. C. muscatense is resolved as the sister species to another endemic fish of the Arabian Peninsula Cyprinion mhalense, with a Kimura-2-Parameter model distance of 5.3%.

One level deep convolutional neural network for facial key points detection

Facial landmark detection has a lot of applications in face recognition, face alignment, facial expression recognition, video surveillance and security systems. In the existing literature, there are multiple methods utilizing convolutional neural networks (CNNs) that address this problem in various ways. In many cases, the models use a tree-like structure of CNNs to achieve better results. This paper proposes a combination of three parallel deep convolutional neural networks (DCNNs) to estimate the accurate localization of each keypoint. The first one focuses on the whole face to outperform five points, including the eyes, nose, and mouth corners. The second one focuses on the eyes-nose parts to outperform three points, specifically the eyes and nose. The last one focuses on the nose-mouth parts to outperform three points, namely the nose and mouth corners. Further, we combine all outputs of the three DCNNs and take the average value of each detected key point as the final output. In the first step, we improvthe the parameter efficiency and accuracy of each DCNNs through a set of experiments using the labeled face parts in-the-wild database (LFPW) and the helen facial feature dataset (Helen). Then, we demonstrate that our approach yields more accurate estimations of facial key points than two state-of-the-art methods and commercial software in terms of accuracy.

Rotation of a Part of the Composite Flap for Simultaneous Gonion Reduction and Malar Augmentation During Rhytidectomy in Asians.

The desired facial shape that Asians aim to achieve through plastic surgery differs from that of westerners. The author facilitates facial volume deflation by using the rotation of a part of the composite flap to the malar area resulting in volumetric augmentation during rhytidectomy; simultaneously, a volumetric reduction was implemented in the gonion. Extended deep plane rhytidectomy with the rotation of a part of the composite flap was performed in 49 patients, whereas extended deep plane rhytidectomy without the rotation of a part of the composite flap was performed in 20 patients. For the results, the satisfaction survey of the surgery was conducted in all patients and by 2 surgeons during a follow-up visit 12 months later. To assess the surgical outcome objectively, the author used the Allergan photometric midface volume deficit scale to measure the midface volume. The midface contour and degree of projection were analyzed using lateral view photographs of the patients. The measurement of segment CM (distance between the lateral canthus and mouth corner) and segment MA (distance from segment CM to the most protruding malar area) was performed. The patients who underwent extended deep plane rhytidectomy with the rotation of a part of the composite flap reported higher overall satisfaction and achieved more favorable results, as evaluated by the 2 aesthetic surgeons (P < 0.05). The scores on the Allergan photometric midface volume deficit scale showed a significant increase before and after the surgery in both groups (P < 0.05), also as evaluated by the 2 aesthetic surgeons. However, the change in scores was found to be higher in the extended deep plane rhytidectomy with the rotation of a part of the composite flap group. The midface contour and degree of projection showed an increase of 20.6% on the right face and 22.7% on the left face, respectively (P < 0.001). Using the rotation of a part of the composite flap during rhytidectomy resulted in overall satisfactory outcomes for all patients. Based on these findings, it can be concluded that the use of this surgical method is beneficial and effective.

Non-invasive detection of mental fatigue in construction equipment operators through geometric measurements of facial features

Introduction: Prolonged operation of construction equipment could lead to mental fatigue, which can increase the chances of human error-related accidents as well as operators’ ill-health. The objective detection of operators' mental fatigue is crucial for reducing accident risk and ensuring operator health. Electroencephalography, photoplethysmography, electrodermal activity, and eye-tracking technology have been used to mitigate this issue. These technologies are invasive and wearable sensors that can cause irritation and discomfort. Geometric measurements of facial features can serve as a noninvasive alternative approach. Its application in detecting mental fatigue of construction equipment operators has not been reported in the literature. Although the application of facial features has been widespread in other domains, such as drivers and other occupation scenarios, their ecological validity for construction excavator operators remains a knowledge gap. Method: This study proposed employing geometric measurements of facial features to detect mental fatigue in construction equipment operators' facial features. In this study, seventeen operators performed excavation operations. Mental fatigue was labeled subjectively and objectively using NASA-TLX scores and EDA values. Based on geometric measurements, facial features (eyebrow, mouth outer, mouth corners, head motion, eye area, and face area) were extracted. Results: The results showed that there was significant difference in the measured metrics for high fatigue compared to low fatigue. Specifically, the most noteworthy variation was for the eye and face area metrics, with mean differences of 45.88% and 26.9%, respectively. Conclusions: The findings showed that geometrical measurements of facial features are a useful, noninvasive approach for detecting the mental fatigue of construction equipment operators.

Deciphering Depressor Anguli Oris for Lower Face Rejuvenation: A Prospective Ultrasound-based Investigation.

The depressor anguli oris muscle (DAO) is a pivotal treatment target when creating a harmonic jawline. However, evidence of its live morphology remains scarce. In this study we aimed to reevaluate the DAO with a facile ultrasound analysis and thereby guide safer and more effective botulinum toxin type A (BTX-A) injection. A prospective ultrasound assessment was conducted in 41 patients. Morphology of the DAO and its relative position to neighboring structures were appraised at the ubiquitous facial landmark, the labiomandibular fold (LMF). Three-dimensional images were captured before and after the patient received the BTX-A injection based on sonographic evidence. The skin-to-muscle depths of the DAO on average (measured from the medial to lateral border) were 5.26, 5.61, and 8.42 mm. The DAO becomes thinner and wider from zone 1 to zone 3 (P < .001). Overlapping lengths of the DAO and the depressor labii inferioris increased from zone 1 to zone 3: 4.74, 9.68, 14.54 mm (P < .001). The medial border of the DAO was located at 4.33, 6.12, 8.90 mm medial to the LMF (zone 1-3), and no muscle fibers of the DAO were observed in zone 1 or zone 2 in nearly one-third of patients. Improvement of the mouth corner downturn angle upon receiving BTX-A injection at zones 2 and 3 were 88.3%, 32.3%, and 14.7% for the neutral, maximum smile, and down-turning mouth corner expressions. This work established an informative ultrasound portrait of the DAO and structures in the perioral region, which suggested the LMF as a convenient landmark for locating the DAO. Injection at the middle and lower thirds of the LMF at a 4- to 5-mm depth is recommended.

Facial artery: anatomical variations in the perioral region in cadavers.

In recent years, there has been an increase in reports of perioral vascular complications resulting from filler injections, such as necrosis of the lip or alar rim, occlusion, and in severe cases, blindness. Conversely, the use of perioral arterial flaps is becoming more prevalent in the treatment of cleft lips, cancer, and trauma. A thorough understanding of perioral arteries is essential to minimize complications and maximize the success of these flaps. However, the course of the facial artery (FA) in the perioral region remains incompletely understood. The aim of this study was to describe the variations of the FA in the perioral region. We dissected 52 embalmed and formaldehyde-fixed Vietnamese cadavers. We then studied the size and distribution of perioral arteries in 102 specimens. The superior labial artery (SLA) was the most common branch, occurring in 87.25% of cadavers, followed by the inferior labial artery (ILA) at 78.43%. The SLA primarily originated above the mouth corner (cheilion), accounting for 91.01% of cases, and predominantly exhibited a tortuous course within the submucosa (78.65%). The ILA's branching pattern varied, but it was primarily located below the cheilion (91.25%). The ILA also followed a twisted path, generally within the submucosa. The ILA exhibited two patterns: the typical pattern, distributed at the vermilion border of the lower lip (8.82%), and the horizontal labiomental artery pattern, which ran horizontally in the middle of the lower lip area (69.61%). At their origin, the SLA and ILA had average external diameters of 1.29 mm and 1.28 mm, respectively. Numerous anatomical variations in the FA in the perioral region were found. A detailed anatomic description, suggested landmarks, and angiography before the procedure will be useful to help doctors avoid complications.

Surgical Corner of the Mouth Lift – Case Study

A smile is an expression of joy and sympathy, serving as a vital element of social communication. The process of aging has a notable impact on both skin elasticity and muscle tone, which consequently results in alterations in the appearance of the corners of the mouth and the overall smile. Notably, the emergence of 'marionette lines,' vertical wrinkles extending from the mouth's corners to the base of the chin, signifies a visible manifestation of the aging process. These changes exert influence on both aesthetic aspects and personal hygiene, potentially leading to the development of inflammatory conditions.This article presents a case study focusing on a female patient who underwent surgical correction of the mouth's corners due to recurrent angular cheilitis. The patient presented with ptotic mouth corners, excessive salivation, and erythema at the angles of the mouth, often accompanied by painful discomfort during exacerbations of the inflammatory condition. The treatment method applied in this specific case involved the utilization of the triangular technique. Subsequent to the surgical procedure, the patient expressed satisfaction with the outcome, and her mouth corners remained free from inflammatory episodes for a duration of two years.

How to Enhance the Success of Selective Neurectomy for Facial Synkinesis by Considering the Patient's Preferences: Lesson Learned from a Retrospective Analysis of 122 Cases.

Facial synkinesis can result in facial tightness, smile dysfunction, and eyelid aperture narrowing due to overactive and uncoordinated muscle activity. We hypothesized that the outcome of a selective neurectomy could rely on the patient's chief complaints. We retrospectively reviewed 122 patients who underwent selective neurectomy at our hospital. Preoperatively, the patients were asked nine questionnaires to identify their two major chief complaints (treatment priorities). Postoperatively, facial tightness, limited mouth movement, and eyelid aperture narrowing were measured. The most common chief complaints in our series were facial tightness (n=38), eyelid narrowing (n=32), and limited mouth movement (n=28); the second most common chief complaints (second priority) were limited mouth movement (n=47), facial tightness (n=21), and eyelid narrowing (n=20). The mean score for facial tightness significantly improved from 4.3 to 1.1 in the first priority group. Among the 28 patients whose corners of the mouth constituted the top priority of surgical correction, the vertical inclination on the affected side significantly improved from 74.1 ± 7.6° to 55.5 ± 6.0°, and the horizontal angles were changed from 4.2 ± 2.7° to 2.0 ± 1.3° after selective neurectomy without statistically significant. Among the 32 patients for whom eyelid narrowing constituted the top priority, the mean eyelid narrowing score improved from 4.5 ± 1.1 to 1.5 ± 1.2. Selective neurectomy can provide a significantly satisfactory outcome regarding facial tightness and eyelid aperture narrowing. The vertical inclination of the mouth corner can be significantly improved, while the improvement of horizontal angles can be suboptimal. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Assessment of effect of menopause on oral health and its awareness in population visiting dental OPD: a hospital-based study

Background: Menopause is a normal mechanism which takes part in every woman’s life. However, the awareness regarding menopause has to be highlighted effectively. Aim of this study was to assess the incidence and frequency of oral symptoms in postmenopausal women as well as to assess the level of awareness of menopause in women. Methods: A hospital-based study using a 60-item questionnaire was conducted on postmenopausal women with age range of 35-70 years for a period of three months. Statistical analyses were performed. Results on continuous measurements were presented on Mean±SD. Descriptive statistics with frequency and percentage were computed. Results: A total of 650 responses were received. In the present study, the mean age of menopause was 54 years. The most prevalent general symptoms reported were tiredness (89.8%), joint pains (89.7%) and irritability (76.5%). The most common oral manifestations of menopause were dryness of mouth (57.1%), altered taste (26.3%) and cracked corners of mouth (25.8%). About 39.8% of postmenopausal women had poor KAP score followed by 34.6% who had an average score while 18.3% had a good score and only 7.2% had scored excellent. Conclusions: Our study showed that the occurrence of classical menopausal symptoms of sweating and hot flushes was lesser in comparison to previous studies on Asian women. The increased incidence of dry mouth could lead to a rise in oral diseases. Moreover, a majority of postmenopausal women had a poor KAP score which showed that the awareness towards menopause needs to be increased.

Gender- and Age-Related Characterization of Lip Morphology: A Three-Dimensional Analysis in a Chinese Population.

Establishing facial anthropometric reference values is essential for diagnosis of deformity, assessment of aging, and planning for aesthetic and reconstructive treatment. This study aimed to provide detailed perioral anthropometric data in relation to sex and age in Chinese persons with a standardized 3-dimensional protocol. Three-dimensional facial photographs were obtained of 60 male and 64 female healthy Chinese participants ages 20 to 35 and 50 to 65 years old, as well as 2 acromegaly patients, with the VECTRA 3D camera. A standardized evaluation was performed to locate 37 perioral landmarks and generate corresponding measurements, including 26 linear distances, 5 ratios, 2 curvatures, 4 areas, and 9 angles. Measurements of different age groups and of different genders were compared, as were measurements of healthy individuals with those of acromegaly patients. Sex discrepancy was noted in philtrum length, width, and area, lip width, and vermilion and cutaneous upper lip area; these were larger in Chinese males than females. However, vermilion heights were similar in both genders. With age, philtrum and cutaneous upper lip height and area, lip width, and angles related to cupid's bow significantly increased, whereas vermilion height and mouth corner angles decreased, and philtrum width, vermilion areas, and lip protrusion remained unchanged. Compared to healthy Chinese patients, acromegaly patients had a larger value for most measurements. Perioral rejuvenation based on detailed 3-dimensional anthropometry showed good results. Chinese males have wider but not thicker lips than females, and aging features thin, flattened, and wide vermilions with a lengthened philtrum in both genders. These data can serve as a reference standard for disease diagnosis, aesthetic procedures, and reconstructive lip surgeries.

Behavioural Analysis of Dogs’ Response to Threatening and Neutral Conspecific Video Stimuli

Dogs’ displacement behaviours and some facial expressions have been suggested to function as appeasement signals, reducing the occurrences of aggressive interactions. The present study had the objectives of using naturalistic videos, including their auditory stimuli, to expose a population of dogs to a standardised conflict (threatening dog) and non-conflict (neutral dog) situation and to measure the occurrence of displacement behaviours and facial expressions under the two conditions. Video stimuli were recorded in an ecologically valid situation: two different female pet dogs barking at a stranger dog passing by (threatening behaviour) or panting for thermoregulation (neutral behaviour). Video stimuli were then paired either with their natural sound or an artificial one (pink noise) matching the auditory characteristics. Fifty-six dogs were exposed repeatedly to the threatening and neutral stimuli paired with the natural or artificial sound. Regardless of the paired auditory stimuli, dogs looked significantly more at the threatening than the neutral videos (χ2(56, 1) = 138.867, p &lt; 0.001). They kept their ears forward more in the threatening condition whereas ears were rotated more in the neutral condition. Contrary to the hypotheses, displacement behaviours of sniffing, yawning, blinking, lip-wiping (the tongue wipes the lips from the mouth midpoint to the mouth corner), and nose-licking were expressed more in the neutral than the threatening condition. The dogs tested showed socially relevant cues, suggesting that the experimental paradigm is a promising method to study dogs’ intraspecific communication. Results suggest that displacement behaviours are not used as appeasement signals to interrupt an aggressive encounter but rather in potentially ambiguous contexts where the behaviour of the social partner is difficult to predict.

"Untying the knot": The primitive orofacial muscle architecture in the gorilla (Gorilla gorilla) as a key to the evolution of hominin facial movement.

The anatomical underpinnings of primate facial expressions are essential to exploring their evolution. Traditionally, it has been accepted that the primate face exhibits a "scala natura" morphocline, ranging from primitive to derived characteristics. At the primitive end, the face consists of undifferentiated muscular sheets, while at the derived end there is greater complexity with more muscles and insertion points. Among these, the role of the human modiolus ("knoten" in German) has been emphasized. Recent studies have challenged this view by revealing significant complexity in the faces of several non-human primates, thereby rejecting the linear notion of facial evolution. However, our knowledge of the facial architecture in gorillas, the second closest living relatives to modern humans, remains a significant gap in the literature. Here, we present new findings based on dissection and histological analysis of one gorilla craniofacial specimen, alongside 30 human hemifaces. Our results indicate that while the number and overall arrangement of facial muscles in the gorilla are comparable to those of chimpanzees and modern humans, several orofacial features distinguish the gorilla's anatomy from that of hominins. Among these are the absence of a modiolus, the continuity of muscular fibers over the region of the mouth corner, the flat (uncurving) sheet of the orbicularis oris muscle, and the insertion of direct labial tractors both anterior and posterior to it. Collectively, the anatomical characteristics observed in the gorilla suggest that the complex anatomy of the hominin face should be considered synapomorphic (shared-derived) within the Pan-Homo clade.

Ultrasonographic analysis of facial skin thickness in relation to age, site, sex, and body mass index.

Numerous nonsurgical but invasive cosmetic procedures are performed blindly in the dermis or subcutaneous fat layer of the facial skin. To measure the numerical skin thickness of the facial areas where dermatological procedures are performed by applying ultrasound techniques, and to make it possible to estimate the skin thickness by investigating the influence of several individual constitutional factors such as age, sex, and body mass index (BMI), so that these variables can be applied to estimate skin thickness. Skin thickness was measured at eight different facial points using an ultrasound machine (Affiniti 50; Philips Inc.). Demographic data were gathered using questionnaires. Manual BMI was calculated from the weight and height of each participant, and individual BMI measurements were performed using a body composition analyzer. In terms of whole skin thickness, the thickest point was the mouth corner, and the thinnest point was the lateral forehead. The thickest point in the epidermis was the chin, and the thinnest point was the nasolabial fold. The thickest point in the dermis was the corner of the mouth, and the thinnest was the lateral forehead. Full skin thickness and dermal thickness were mostly lower in females. Skin thickness was not significantly correlated with BMI. The skin thickness at different points on the face was variable, and realistic data about skin thickness can be obtained by in vivo ultrasonographic analysis of the skin.

International Consensus Recommendations on the Aesthetic Usage of Ready-to-Use AbobotulinumtoxinA (Alluzience).

Alluzience (abobotulinumtoxinA RTU, Galderma; Lausanne, Switzerland) is the first ready to use (RTU) botulinum toxin-type A liquid solution approved for the treatment of glabellar lines in Europe. In this article, the authors provide consensus recommendations on the aesthetic usage of abobotulinumtoxinA RTU. Members of the International Board on Alluzience (IBA) convened to develop consensus on the treatment of glabellar lines as well as other facial wrinkles based on their own extensive experience. Consensus recommendations were developed to provide practical guidelines for injection of abobotulinumtoxinA RTU. General guidance on proper assessment, treatment planning, and patient education is provided, as well as specific injection guidelines per indication. Indications covered include glabellar lines, crow's feet, horizontal forehead lines, lateral eyebrow lift, lower eyelid wrinkles, bunny lines, drooping nasal tip, perioral wrinkles, drooping mouth corners, masseter hypertrophy, hollow cheek lines, dimpled chin, and platysmal bands. These guidelines provide a practical framework to support routine injection of facial muscles with Alluzience.

BELL’S PALSY in a girl child: A rare case report with review of literature

Bell's Palsy is a unilateral acute peripheral facial nerve palsy of sudden onset and unknown aetiology. Bell's Palsy is common in adults but rarely seen in children. Inability to close the unilateral eye, drooping of corner of mouth, with drooling of saliva and unable to smile on affected side are few important clinical features of Bell's Palsy. Management of Bell's Palsy in children is basically symptomatic only. Multivitamins with light physiotherapy are all that are helpful to manage most of the Bell's Palsy cases in children. Overall, Bell's Palsy in children is self-limiting with early and complete recovery.

Racehorse welfare across a training season.

Racehorse welfare is gaining increasing public attention, however scientific evidence in this area is lacking. In order to develop a better understanding of racehorse welfare, it must be measured and monitored. This is the first study to assess racehorse welfare using scientific objective methods across a training season. The aim of this study was threefold, firstly to investigate welfare measures which could be used in the first welfare assessment protocol for racehorses. Secondly, to understand the effect that a racing and training season had on individual racehorses and thirdly to identify risk factors for both good and poor welfare. Thirteen racehorse training yards were visited at the beginning and the peak of the racing season in England. Behavioral observations along with individual environmental and animal-based welfare measures were carried out on 353 horses in 13 training yards selected for variability. In our sample the horses were generally in good physical health: 94% of horses recorded as an ideal body condition score, no horses had signs of hoof neglect and 77.7% had no nasal discharge. The overall prevalence of external Mouth Corner Lesions was 12.9% and was significantly higher for Flat racing than Jump racing horses. The majority of horses (67.5%) showed positive horse human interactions. When stabled 54.1% horses had physical social contact and nasal discharge was not associated with increased physical contact. The training season significantly affected Human Reactivity Tests, Horse Grimace Scale scores and time spent resting and feeding. A total of 14.5% of horses displayed stereotypic behavior on at least two occasions. Horses with windows in their stables spent more time surveying their surroundings. Overall, in this population of racehorses, horses spent around a third of their daytime feeding (33.7%) followed by time spent standing resting (22.6%). The welfare assessment protocol used in this study is suitable for use in industry to collect welfare data on racehorses.