Skull Model Research Articles

ИСПОЛЬЗОВАНИЕ НАВИГАЦИОННОЙ СИСТЕМЫ, ОСНОВАННОЙ НА ТЕХНОЛОГИИ ДОПОЛНЕННОЙ РЕАЛЬНОСТИ, В ХИРУРГИЧЕСКОМ ЛЕЧЕНИИ ОПУХОЛЕЙ ОРБИТЫ

Objective. To assess the effectiveness and feasibility of using an intraoperative navigation system based on augmented reality technology in the surgical treatment of intra-orbital tumors. Methods. Two patients with intra-orbital tumors were operated on with the application of the intraoperative navigation system. The virtual volumetric model was designed on the basis of files in the Digital Imaging and Communications in Medicine (DICOM) format, taking into account the fact that the quality of reconstruction depends on the quality of the input data and the accuracy of the reconstruction system. The required structures and parameters of color rendering for inclusion in the model were selected taking into consideration a specific clinical situation. Then the model was subjected to processing and modification to facilitate visualization. The prepared and optimized model was loaded into Microsoft HoloLens2 augmented reality glasses. In the preoperative period, using the possibilities of full screen image zoom and rotation of 3D model, the planning of the surgical intervention was carried out with the participation of all members of the surgical team. Intraoperatively, a 3D skull model was superimposed on the patient along bony landmarks (lower orbital edge and nasal bones). Surgical access and surgery were performed in the projection of the visualized tumor. Results. In the first case, the surgical planningas the preoperative method of pre-visualising asurgical intervention was used by means of the possibilities of model zooming and rotating; a detailed preoperative tumor assessment was made. In the second case, the navigation system was used in the process of diagnostic orbitotomy to facilitate the access to the tumor. Conclusion. Augmented reality allows highly detail visualization of individual anatomical models. Models are interactive, adaptive to real time and manipulating does not require the special skills. The technologies are flexible and can be programmed to perform a number of tasks (diagnostics, preoperative planning and intraoperative navigation). Models might be used for surgical training of surgeons to possess the skills. What this paper adds For the first time, the possibility of a navigation system application based on augmented reality technology in the surgical treatment of intra-orbital tumors has been shown. The technique has been found to be useful both in the preoperative planning and during surgical intervention.

Research on spatial motion safety constraints and cooperative control of robot-assisted craniotomy: Beagle model experiment verification.

Traditional craniotomy depends primarily on the experience of the surgeon. However, the accuracy of manual operation is limited and carries certain surgical risks. The interaction method of current robot-assisted craniotomy is unnatural and inadaptive to the operating style of the surgeon. In this research, we built a hands-on synergistic robotics craniotomy system with human-machine collaboration. Safe isometric surfaces and virtual restraint methods are combined to achieve highly accurate, efficient, minimally invasive and safe craniotomy. Fifteen three-dimensional (3D)-printed beagle skull models were used to evaluate the system accuracy and the related image guidance process. It mainly includes the design of the surgical plan, the adopted strategy based on motion constraint and safe isometric surface, and the impedance control method based on the position inner loop via the human-machine collaboration method. The trajectory tracking experiment was performed by applying human-machine collaboration, and completed an experiment on the 3D-printed beagle skull models involving drilling and milling of the skull performed by the robot, and evaluation of accuracy via computed tomographic (CT) scanning verification after the operation. The 3D-printed beagle skull model experiment shows that the average errors for the top surface and the bottom surface, and the angle error were 0.81±0.15mm, 0.89±0.12mm, and 1.74°±0.16°, respectively. The average milling position errors for the top and bottom surfaces were 0.87±0.19 and 0.93±0.22mm, respectively. The performance of the robot system was evaluated and verified using a 3D-printed beagle model experiment. The proposed collaborative surgical robot system is feasible and can complete a craniotomy, with improved accuracy and surgical safety.

Biomechanical evaluation of two miniplate fixations applied in the anterior region after Le Fort I osteotomy: an experimental study

The aim of this experimental study was to evaluate the reliability of two-plate fixations applied to the anterior region of the maxilla after Le Fort I osteotomy in terms of stability. Twenty polyurethane-based skull models were used to evaluate two fixation techniques. Two groups consisting of four and two L-shaped titanium miniplates were tested. Each group was tested with the application of vertical forces in the anteroposterior direction using a servohydraulic testing unit. The displacement values in each group at each stage (from 10 N - 120 N) were compared using the Mann-Whitney U test. The displacement values for the two groups were not statistically significant up to 20 N, but differed significantly between 20 N and 120 N (p < 0.05). The results showed that the biomechanical behaviour of fixation with four miniplates was better than that of two after a load of 20 N. It can be concluded that when the amount of maxillary advancement is increased to 10 mm or more, fixation with only two plates does not provide sufficient stability experimentally.

Effects of different types of maxillary protraction on maxilla with finite element analysis.

To compare two different skeletal anchorage methods with finite element analysis in the treatment of Class III patients with maxillary retrognathia. Two different treatment scenarios were performed on skull model obtained from computerized tomography images of skeletal Class III patients with maxillary retrognathia and finite element analysis was performed. In the first group; mini plates were simulated on infra zygomatic crest. A unilateral 500 g protraction force was applied to the face-mask. In the second group; mini plates were simulated in infrazygomatic crest and mandibular symphysis. Then, 500g protraction force was applied with Class III elastic between the miniplates. Von Misses stresses and displacement values were evaluated comparatively. In Class III elastic group, maximum Von Misses stress occurred around infra zygomatic crest and symphysis anchored with 0.078 MPa. The maxillary posterior region and paranasal regions were the areas showing the highest Von Misses tension after infra zygomatic crest and symphysis. In the face-mask group, the most common site of Von Misses stress in nasomaxillary complex and alveolar structures were infra zygomatic area where plaques were applied, followed by pterygomaxillary suture. Tensile forces are reduced especially in these two areas by spreading to surrounding structures. In both methods, it was determined that the amount of force transmitted to circumaxillary sutures was sufficient to induce the formation of osteogenesis in these regions.

A Customized Technique of Cranioplasty for Patients with Large Skull Defects: A Technical Note

In our technical note, we have presented a technique of cranioplasty for large skull defects. A thin-slice computed tomography scan is performed. A model of the skull is constructed using a desktop 3-dimensional printer from the computed tomography scan. The skull model is filled with towels of soft cotton and inserted in a sterile thin plastic bag. The implant is molded intraoperatively on the skull model under sterile conditions. After surgical exposure of the skull defect, the implant is inserted and fixed using miniplates and miniscrews. The technique was used in 6 patients and described in 2 representative cases. The required time and cost are significantly lower than those for other techniques used for preoperative manufacture of implants. No technique-related complications occurred. The radiological and cosmetic results were satisfactory. In the present case series, no early or delayed complications occurred. The presented technique is simple, safe, and time- and cost-effective. The technique and results are reproducible.

Forensic Facial Reconstruction Using 3D Printing

The paper presents the application of 3D printing in the forensic field in order to perform facial reconstruction on a 3D printed replica of the victim�s skull. Firstly, imagine data from a computed tomography of a skull was converted into a 3D model. Then, the 3D skull model was sliced and printed in different positions in order to optimize the 3D printing configuration. Since the quality of the 3D printing process depends on the thermal and rheological properties of the 3D printing filaments, the rheological behavior of the ABS was investigated using melt flow rate and capillary rheometry. Lastly, an accurate skull replica was achieved using the optimal printing parameters. The 3D printed skull was used to perform the facial reconstruction of the victim by the forensic team. Based on the results of the present research, the 3D printing technology is a feasible solution to obtain anatomically accurate skull replicas.

Clinical Analysis of the Effects of Frontal Bone Reconstruction and Cranial Suture Reconstruction in the Operation of Simple Premature Closure of Frontal Suture in Infants.

To compare, and to analyze the effects of cranial suture reconstruction and frontal bone reconstruction in the operation of premature closure of the sagittal suture in infants. A total of 35 infants with simple premature closure of frontal suture were divided into the experimental group (n=18) and the control group (n=17). In the experimental group, the skull model was reconstructed by imaging examination and three-dimensional (3D) printing technique before operation, and the frontal bone reconstruction was used to guide the surgical treatment of cranial stenosis. In the control group, the skull model was reconstructed by imaging examination and 3D printing technique before operation, and the cranial suture reconstruction was performed by the same operator. The surgical effects of the two groups were compared. During the 12-month follow-up after operation, the interfrontal angles of scaphoid malformation were 153.67 ± 12.77 and 128.67 ± 7.90 in the experimental and control groups, respectively. The difference between the two groups was statistically significant. Frontal bone reconstruction surgery can guide the operation of cranial stenosis, significantly improve the surgical treatment effect of infants with frontal suture, and esthetically enhance the head type of infants. Moreover, its effect is better than that of traditional operation, which is worth given significant attention in clinical settings.

Clinical Analysis of the Effects of Cranial Suture Reconstruction and Frontal Frame Band Transfer in the Operation of Premature Closure of Coronal Suture in Infants.

To compare, and to analyze the effects of fronto-orbital band anterior displacement in the operation of premature closure of coronal suture in infants. A total of 31 infants with premature closure of coronal suture were randomly divided into two groups; experimental group (n=16) and control group (n=15). In the experimental group, the skull model was reconstructed by an imaging examination and three-dimensional (3D) printing technique before the operation, and the fronto-orbital band was anteriorly displaced during the operation to guide the surgical treatment of craniosynostosis. In the control group, the skull model was reconstructed by an imaging examination and 3D printing technique before the operation, and the fronto-orbital band was not anteriorly displaced during the operation by the same operator. The surgical effects of the two groups were compared. During the 12-month follow up after the operation, the cephalic index of short head deformity in the experimental group was 80.7 ± 1.1, while that in the control group was 89.3 ± 4.5. There was a significant difference between the two groups. Fronto-orbital band anterior displacement may guide the operation of craniosynostosis and significantly improve the effectiveness of surgical treatment of children with premature closure of coronal suture, which is worth popularizing in the clinical management of cases.

Evaluation of stress distribution in maxilla, mandible, and glenoid fossa after Class III intermaxillary traction: A three-dimensional finite element analysis study

Aim: In this study, we aimed to evaluate the stress distribution on maxilla, mandible, and glenoid fossa after application of Class III intermaxillary anteroposterior orthopedic forces of 150, 250, and 400 gas applied to a three-dimensional (3D) model of the young human dry skull. Methods: A 3D finite element model was developed from the computed tomography images of a growing boy (age, 13 years). ANSYS (version 16.0) software used to simulate Class III force of progressively increasing intensity over maxilla, mandible, and glenoid fossa to quantify the biomechanical reaction with two components, direction and stress. Results: We quantified detailed changes in the maxillofacial sutures, dentition, mandible, and glenoid fossa with bone-anchored maxillary protraction (BAMP) to analyze their effects. Conclusions: As the force increases from 150, 250 to 400 g, stresses are increased on all structures associated except maxillary central incisor which show a decrease in the stresses. Although forces were for maxillary protraction, stress generated at the circummaxillary sutures was minimal. As with any other Class III force, stresses were distributed on whole of condyle, capsular ligament, and minimal at glenoid fossa. This suggests that BAMP has more of mandibular restraining effect.

Custom-made Implants for Chronic In Vivo Electrophysiological Recording From Primate’s Brain Based on the Reconstructed Skull Model

Background. In-vivo neural recordings from primates require to install implants on the skull of the animal. Despite some improvements, current routines still risk predisposition to infection and failure or impose constant discomfort by placing heaviness on the top of the head. New Methods. Using a custom-designed imaging adapter, MR and CT imaging of the head region were obtained. Then, based on reconstructed model of skull the implants were designed and constructed by CNC machine. During the surgical operation, the position of each implant was sketched on the skull and implants were slipped onto their predicted site and followed their sketched boundaries without any manual reshaping. Results. We have performed this procedure on two monkeys. After surgery, location of implants has been verified by CT imaging. The recovery period was without significant complications with minimal infection. Comparison with Exiting methods.Our experiment showed that through the application of image-guided design, it is possible to better utilize the skull area to gain access to brain regions. At the same time, our method reduced the possibility of gap formation between implant and skull, open skin margins, and reduced the time and cost of operation which altogether results in a reduced overall chance of infection and failure and provides animal friendly operational surgery procedure. Conclusion. Despite some improvements, more refinements of methodology are still required. Here, we propose and report an improvement for the design and installation of biocompatible implants in low cost providing access to at least three brain regions.

Clinical Analysis of the Effects of Cranial Suture Reconstruction and Frontal Frame Retraction in the Operation of Premature Closure of the Sagittal Suture in Infants.

To compare and analyze the effects of cranial suture reconstruction and frontal frame retraction for surgical treatment of premature closure of the sagittal suture. Infants with premature closure of the sagittal suture were included in this study. All infants underwent preoperative skull model reconstruction using imaging techniques and 3D printing. The infants were then allocated to either the experiment group, where the frontal frame retraction was used to guide the surgical treatment of cranial stenosis, or the control group, where traditional cranial suture reconstruction was performed. All interventions were performed by the same operator. The surgical effects of the two groups were compared. Overall, 28 infants were enrolled in this study, with 15 infants in the experimental group and 13 in the control group. In the one-year post-operative follow-up visit, the cephalic index of scaphoid malformation was 78.3 ± 1.4 in the experimental group and 69.0 ± 4.2 in the control group. The difference between the two groups was statistically significant. Frontal frame retraction surgery can guide the surgical procedure for cranial stenosis, significantly improve the treatment outcome in children with premature closure of the sagittal suture, and improve the form of the head aesthetically in children, and the effect is better than traditional operation; therefore, the technique is worth popularizing in the clinic.

Forensic Recreation and Visual Representation of Greek Orthodox Church Saint Eftychios of Crete.

Facial reconstruction is employed in medical science and archaeology. Though quite popular as anthropological method, it has not so far been used in the orthodox ecclesiastical tradition. This work presents the facial reconstruction of St Eftychios of Crete, who lived between the ninth and tenth centuries. Computed tomography and reverse engineering methods were employed to complete the task. Reconstruction of the mandible and the missing left zygomatic arch was implemented following the Sassouni method. The American method was followed for the soft tissues, with clay deposition of appropriate thickness, on the surface of the skull model. The eyes, nose, and lips were added based on the dimensions of the underlying bone structures. Long hair and beard were added, according to the classic Byzantine tradition pattern of the time period. The final bust developed was then digitized, using a 3D non-contact laser scanner. The 3D geometry produced was employed to produce a mold with vacuum casting techniques. This mold provides the ability to produce copies of the bust, if needed. At the same time, a realistic 3D representation of the Saint's bust was developed, with the aid of special software, in order to compare the traditional forensic reconstruction to the pure digital one. This work is the first case of a Saint's facial reconstruction in the Orthodox Church. The facial reconstruction process, with all the limitations considered, offers the ability to present a realistic aspect of a Greek Orthodox Church Saint, in a form that is easily accessible. Both physical and digital facial reconstruction processes were based on scientific data, so they were as accurate as possible, considering that the mandible was missing in the skull. The facial reconstruction was entirely implemented in Greece creating the basis for similar work in the future. The final bust developed was donated to the Odigitria Monastery, to be exhibited to its visitors.

Automated filtering and polygonal reconstruction of virtual skull model based on computed tomography

A method of automated filtering and polygonal reconstruction of the skull virtual model using the methods of “Marching cubes” and “Connected component labeling” is considered. An algorithm for effective software implementation is described. A computational experiment on computed tomography data consisting of 244 DICOM images is presented. The experimental results confirm the correctness and computational efficiency of the algorithm.

HeaDax: A simple pre-surgical procedure for localizing superficial brain lesions in resource-limited environments

Background: Intracranial convexity lesions are poorly defined by recognizable anatomical landmarks. Even in expert hands, exact localization of small subcortical lesion and its projection to the skull is sometimes unreliable and can cause potential surgical complications. In this report, a simple and handy technique for localizing superficial intracranial lesions on the scalp under computed tomography (CT)-scan guidance is described.Methods: This technique, HeaDax, is based on using extracranial landmarks. We constructed an isosceles square triangle with three pieces of copper electrical wire and placed it on the skin scalp. Then, we took a CT-scan but without the need of the classic head reference planes (e.g., orbitomeatal or along the orbital roof).Results: For the measurements, we need to have the intracranial lesion located on the CT slice with respect to the two landmarks which are the height and hypotenuse of the triangle. The promising preliminary results of HeaDax applied to a phantom skull model encourage us to use it successfully for our first patient presenting a right subcortial supramarginal retrorolandic cavernoma.Conclusion: HeaDax procedure is a good alternative for localizing superficial intracranial lesions on the skin scalp under CT-scan or magnetic resonance imaging guidance. It can be used as a substitute when stereotactic and neuronavigation systems are not easily available, especially in developing countries and in resource-limited environments. HeaDax has a true potential for further developments and applications in cranial surgery.

Synthesis and Visualization of Photorealistic Textures for 3D Face Reconstruction of Prehistoric Human

Reconstruction of face 3D shape and its texture is a challenging task in the modern anthropology. While a skilled anthropologist could reconstruct an appearance of a prehistoric human from its skull, there are no automated methods to date for automatic anthropological face 3D reconstruction and texturing. We propose a deep learning framework for synthesis and visualization of photorealistic textures for 3D face reconstruction of prehistoric human. Our framework leverages a joint face-skull model based on generative adversarial networks. Specifically, we train two image-to-image translation models to separate 3D face reconstruction and texturing. The first model translates an input depth map of a human skull to a possible depth map of its face and its semantic parts labeling. The second model, performs a multimodal translation of the generated semantic labeling to multiple photorealistic textures. We generate a dataset consisting of 3D models of human faces and skulls to train our 3D reconstruction model. The dataset includes paired samples obtained from computed tomography and unpaired samples representing 3D models of skulls of prehistoric human. We train our texture synthesis model on the CelebAMask-HQ dataset. We evaluate our model qualitatively and quantitatively to demonstrate that it provides robust 3D face reconstruction of prehistoric human with multimodal photorealistic texturing.

Model Experimental Study of Man-Machine Interactive Robot-Assisted Craniotomy.

To evaluate the feasibility, safety, and accuracy of the new man-machine interactive robotic system in model experiment. The implantation of the 8 to 10 bone screws over the skull model obtained from real patient's digital imaging and communications in medicine (DICOM), three-dimensional spiral computed tomography (CT) scans were taken. The end of the robotic arm was replaced with standard parts (including marker ball) for cone beam computed tomography (CBCT) scanning. The marker ball and marker pin were segmented and marked and exported via txt format. The position of the robotic end and model was obtained through the conversion of spacious position of standard parts and the executive end was replaced eventually. The water balloon was placed inside the skull model to imitate the dura mater and the destruction was documented for the system's safety. The system accuracy was evaluated by the error between the actual drilling position and the virtual plan and selection of 14 points of the skull window of milling pathway, monitored intraoperatively via Micron Tracker system and the overall skull window overlapped percentage via Mimics. Five model experiments were successfully performed with the average registration time of 3 minutes without destruction of balloon. The error of the outer table was 0.85 ± 0.45 mm, the inner table was 0.78 ± 0.49 mm, the line segment error of milling cutter was 0.93 ± 0.50 mm and the overall skull window overlapped percentage was 97.37% ± 0.78%. The system shows safety, accuracy, and reliability which can be an optional assistant method for craniotomy in the future.

Three-Dimensional Skull Model for Endoscopic Skull Base Surgical Training

Nebor, Ivanna; Hussein, Ahmed; Montemagno, Kora; Fumagalli, Rebecca; Labiad, Ikrame; Anderson, Zoe; Xu, Alice; Sedaghat, Ahmad; Patil, Yash; Forbes, Jonathan A MD Author Information

Comparison of Three Canine Models for Teaching Veterinary Dental Cleaning

Veterinary dental cleaning prevents and treats periodontal disease, one of the most common diagnoses in small animal practice. Students learn to perform dental cleaning through deliberate practice, which can be gained through working on models. This study compared educational outcomes after students ( n = 36) were randomized to practice on one of three dental cleaning models: a low-fidelity ceramic tile, a mid-fidelity three-dimensional (3D) printed canine skull model, or a high-fidelity canine head model. Students provided survey feedback about their model and later performed a dental cleaning on a canine cadaver head while being video-recorded. Experts ( n = 10) provided feedback on each model. Experts agreed that all models were suitable for teaching dental cleaning, but the 3D skull and full head models were more suitable for assessing student skill ( p = .002). Students were also more positive about the realism and features of those two models compared to the tile model. Students practicing on each of the models were equally effective at removing calculus from the cadavers’ teeth. Students who learned on the tile model were a median of 4 minutes slower to remove calculus from their cadaver’s teeth than students who trained on the canine head model. Although students may be more accepting of the 3D skull and full head models, all three models were equally effective at teaching the skill. Experts approved all models for teaching, but recommended the 3D skull or full head model if student skills were to be assessed. Low-fidelity models remain effective training tools with comparable learning outcomes.

Canine Skull Digitalization and Three-Dimensional Printing as an Educational Tool for Anatomical Study.

This article aims to standardize 3D scanning and printing of dog skulls for educational use and evaluate the effectiveness of these anatomical printed models for a veterinary anatomy course. Skulls were selected for scanning and creating 3D-printed models through Fused Deposition Modeling using acrylonitrile-butadiene-styrene. After a lecture on skull anatomy, the 3D-printed and real skull models were introduced during the practical bone class to 140 students. A bone anatomy practical test was conducted after a month; it consisted in identifying previously marked anatomical structures of the skull bones. The students were divided into two groups for the exam; the first group of students took the test on the real skulls, whereas the second group of students took the test on 3D-printed skulls. The students' performance was evaluated using similar practical examination questions. At the end of the course, these students were asked to answer a brief questionnaire about their individual experiences. The results showed that the anatomical structures of the 3D-printed skulls were similar to the real skulls. There was no significant difference between the test scores of the students that did their test using the real skulls and those using 3D prints. In conclusion, it was possible to construct a dynamic and printed digital 3D collection for studies of the comparative anatomy of canine skull species from real skulls, suggesting that 3D-digitalized and-printed skulls can be used as tools in veterinary anatomy teaching.

Kinect-driven Patient-specific Head, Skull, and Muscle Network Modelling for Facial Palsy Patients

Background and ObjectiveFacial palsy negatively affects both professional and personal life qualities of involved patients. Classical facial rehabilitation strategies can recover facial mimics into their normal and symmetrical movements and appearances. However, there is a lack of objective, quantitative, and in-vivo facial texture and muscle activation bio-feedbacks for personalizing rehabilitation programs and diagnosing recovering progresses. Consequently, this study proposed a novel patient-specific modelling method for generating a full patient specific head model from a visual sensor and then computing the facial texture and muscle activation in real-time for further clinical decision making. MethodsThe modeling workflow includes (1) Kinect-to-head, (2) head-to-skull, and (3) muscle network definition & generation processes. In the Kinect-to-head process, subject-specific data acquired from a new user in neutral mimic were used for generating his/her geometrical head model with facial texture. In particular, a template head model was deformed to optimally fit with high-definition facial points acquired by the Kinect sensor. Moreover, the facial texture was also merged from his/her facial images in left, right, and center points of view. In the head-to-skull process, a generic skull model was deformed so that its shape was statistically fitted with his/her geometrical head model. In the muscle network definition & generation process, a muscle network was defined from the head and skull models for computing muscle strains during facial movements. Muscle insertion points and muscle attachment points were defined as vertex positions on the head model and the skull model respectively based on the standard facial anatomy. Three healthy subjects and two facial palsy patients were selected for validating the proposed method. In neutral positions, magnetic resonance imaging (MRI)-based head and skull models were compared with Kinect-based head and skull models. In mimic positions, infrared depth-based head models in smiling and [u]-pronouncing mimics were compared with appropriate animated Kinect-driven head models. The Hausdorff distance metric was used for these comparisons. Moreover, computed muscle lengths and strains in the tested facial mimics were validated with reported values in literature. ResultsWith the current hardware configuration, the patient-specific head model with skull and muscle network could be fast generated within 17.16±0.37s and animated in real-time with the framerate of 40 fps. In neutral positions, the best mean error was 1.91 mm for the head models and 3.21 mm for the skull models. On facial regions, the best mean errors were 1.53 mm and 2.82 mm for head and skull models respectively. On muscle insertion/attachment point regions, the best mean errors were 1.09 mm and 2.16 mm for head and skull models respectively. In mimic positions, these errors were 2.02 mm in smiling mimics and 2.00 mm in [u]-pronouncing mimics for the head models on facial regions. All above error values were computed on a one-time validation procedure. Facial muscles exhibited muscle shortening and muscle elongating for smiling and pronunciation of sound [u] respectively. Extracted muscle features (i.e. muscle length and strain) are in agreement with experimental and literature data. ConclusionsThis study proposed a novel modeling method for fast generating and animating patient-specific biomechanical head model with facial texture and muscle activation bio-feedbacks. The Kinect-driven muscle strains could be applied for further real-time muscle-oriented facial paralysis grading and other facial analysis applications.