Face View Research Articles

Buccal Fat Pad Sculpting for Lower Facial Contouring With 3-Dimensional Volume Assessment

Buccal fat pad sculpting and removal (BFPS) can create narrowing of the lower 1/3rd of the face by selective removal and reduction of soft tissue volume. Three-dimensional (3D) imaging allows for quantitative and objective assessment of volume changes over traditional 2-dimensional photographs that has not been previously studied in BFPS. A prospective study was designed in consecutive subjects undergoing BFPS from April 2018 through March 2020. Only those patients that underwent solely BFPS were included. VectraXT 3D imaging and software was used to compare preoperative and postoperative volume changes. Fifteen patients were enrolled in the study with 2 males and 13 females. The mean length of follow up was 7.7 months (range: 1-21 months). All patients were found to have volume reduction in the area evaluated. The mean volume reduction of the selected mid-lower face in the frontal view was 7.2 mL on the left side and 7.5 mL on the right side. There was no statistical difference between the volume change when the 2 sides were compared (P= 0.82). This study demonstrate the use of 3D photography to objectively and quantitatively assess volume change following BFPS and that the volume removed is significant enough to demonstrate favorable results using 3D imaging. Buccal fat pad sculpting is a safe and reliable option for creating a narrowed lower one-third of the face. This is accomplished by selective fat removal and cautery induced reduction of the lower one-third of the face soft tissue volume. VectraXT 3D imaging and analysis is a powerful tool to objectively and quantitatively assess volume changes in BFPS.

Turning the Face Inversion Effect on Its Head: Violated Expectations of Orientation, Lighting, and Gravity Enhance N170 Amplitudes.

Face inversion effects occur for both behavioral and electrophysiological responses when people view faces. In EEG, inverted faces are often reported to evoke an enhanced amplitude and delayed latency of the N170 ERP. This response has been attributed to the indexing of specialized face processing mechanisms within the brain. However, inspection of the literature revealed that, although N170 is consistently delayed to a variety of face representations, only photographed faces invoke enhanced N170 amplitudes upon inversion. This suggests that the increased N170 amplitudes to inverted faces may have other origins than the inversion of the face's structure. We hypothesize that the unique N170 amplitude response to inverted photographed faces stems from multiple expectation violations, over and above structural inversion. For instance, rotating an image of a face upside-down not only violates the expectation that faces appear upright but also lifelong priors about illumination and gravity. We recorded EEG while participants viewed face stimuli (upright vs. inverted), where the faces were illuminated from above versus below, and where the models were photographed upright versus hanging upside-down. The N170 amplitudes were found to be modulated by a complex interaction between orientation, lighting, and gravity factors, with the amplitudes largest when faces consistently violated all three expectations. These results confirm our hypothesis that face inversion effects on N170 amplitudes are driven by a violation of the viewer's expectations across several parameters that characterize faces, rather than a disruption in the configurational disposition of its features.

Effects on applying micro-film case-based learning model in pediatrics education

BackgroundIn view of the harsh reality Chinese paediatricians face, the challenge of paediatric education is about instilling not only knowledge and clinical skills but also resilience and beliefs. The aim of the study is to explore a more effective method than the traditional lecture-based learning (LBL) model for optimizing educational outcomes by establishing an innovative, comprehensive, case-based learning (CBL) model combined with the micro-film technique (MF + CBL). This approach has four important components: interests (attraction), knowledge application, competency, and scenario coping skills.MethodsExperimental research was conducted via a controlled parallel group study. The total sample of 104 senior-year students (Chinese) majoring in clinical medicine was randomly divided into two groups. The experimental group was exposed to the MF + CBL model and the control group to the LBL model. Overall, the results were assessed after an 8-week course via a student self-assessment questionnaire, a satisfaction survey and the final examination.ResultsThe experimental group generally performed better than the control group on the student self-assessment (P<0.05), satisfaction survey (P<0.05), and final examination (80.02 ± 3.77 vs 73.65 ± 3.69, P = 0.000). The open question at the end of the questionnaire revealed that a small number of students did not favour the MF + CBL model due to its time- and energy-consuming features.ConclusionsCompared with LBL, the MF + CBL model was an innovative teaching method that promoted more comprehensive quality development. It represents an alternative model for optimizing the capacity of future paediatric doctors.

Face Detection of Thermal Images in Various Standing Body-Pose using Facial Geometry

Automatic face detection in frontal view for thermal images is a primary task in a health system e.g. febrile identification or security system e.g. intruder recognition. In a daily state, the scanned person does not always stay in frontal face view. This paper develops an algorithm to identify a frontal face in various standing body-pose. The algorithm used an image processing method where first it segmented face based on human skin’s temperature. Some exposed non-face body parts could also get included in the segmentation result, hence discriminant features of a face were applied. The shape features were based on the characteristic of a frontal face, which are: (1) Size of a face, (2) facial Golden Ratio, and (3) Shape of a face is oval. The algorithm was tested on various standing body-pose that rotate 360° towards 2 meters and 4 meters camera-to-object distance. The accuracy of the algorithm on face detection in a manageable environment is 95.8%. It detected face whether the person was wearing glasses or not.

Application of Facial Symmetrical Characteristic to Transfer Learning

Most face detection and recognition tasks are based on the training of intact facial images and corresponding labels. Both the three‐dimensional (3D) structure and two‐dimensional (2D) appearance from the frontal view of human faces are bilaterally symmetrical in general. However, sometimes, illumination on the left and right halves of faces is uneven. In such cases, the symmetrical characteristic of human faces can facilitate expressing distinct identity information. This is because even if one side of the facial image is corrupted by noise, the opposite side can still be used for feature extraction. This paper proposes an automatic selection of the better half of the face using only a half‐face for identity recognition. Unlike the MegaFace challenge of recognizing millions of identities in the wild, this paper focuses on building recognition systems for a small number of people with fewer training images; the recognition system can, for example, build access control systems for research laboratory members or family members. This paper proposes an artificial face image construction method and a half‐face training strategy for transfer learning of pretrained conventional neural network models. Extensive experimental results show that the proposed method improves the performance of state‐of‐the‐art models by utilizing the symmetrical characteristics of human faces. © 2020 Institute of Electrical Engineers of Japan. Published by Wiley Periodicals LLC.

Intraoperative Three-dimensional Imaging of Ventricular Septal Defects in Children Using Epicardial Echocardiography: A Novel Approach

To assess the feasibility and accuracy of intraoperative three-dimensional (3D) epicardial en face images of ventricular septal defects (VSD) in children using the 3D transesophageal echocardiography (TEE) probe as an epicardial probe. This was a prospective nonrandomized blinded observational study. The study was conducted at a single tertiary cardiac care center. Fifty pediatric patients, weighing between 5.0 kg and 20 kg, who were scheduled for elective surgical closure of their VSDs, prospectively were recruited for this study. Epicardial 3D images were acquired using the full-volume mode. VSD location and size were determined from the 3D data sets using multiplanar reconstruction mode (QLAB 9) by a blinded investigator. The accuracy in terms of location and size was compared with surgical findings. In 50 study subjects, 54 VSDs were located by epicardial 3D echocardiography (3DE): 12 perimembranous, 17 inlet, eight muscular, 15 malaligned, and two outlet. Average image acquisition time was 4.96 (±1.47) minutes. Average image reconstruction time was 6.18 (±1.93) minutes. Good en face views of the VSD could be rendered in all patients (100% feasibility). The highest image quality was for perimembranous and malaligned VSDs. The location of VSD by 3DE corresponded precisely with surgical findings (100% accuracy). With linear regression analysis, excellent correlation was observed between the diameters measured by surgery and that measured by 3DE from the right ventricle side (r2 = 0.97, p < 0.001). The authors' study demonstrated that diagnostic quality 3D en face images of VSD can be obtained intraoperatively using 3D epicardial echocardiography. The short acquisition and reconstruction times make this technique clinically applicable.

Three-Dimensional Echocardiographic Method for the Visualization and Assessment of Specific Parameters of the Pulmonary Veins.

The dimensions of the pulmonary veins are important parameters when planning pulmonary vein isolation (PVI), especially with the cryoballoon ablation technique. Acknowledging the dimensions and anatomical variations of the pulmonary veins (PVs) may improve the outcome of the intervention. Conventional 2D transoesophageal echocardiography can only provide limited data about the dimensions of the PVs; however, 3D echocardiography can further evaluate relevant diameters and areas of the PVs, as well as their spatial relationship to surrounding structures. In previous literature data, parameters influencing the success rate of PVI have already been identified. These are the left lateral ridge, the intervenous ridge, the ostial area of the PVs and the ovality index of the ostium. Proper imaging of the PVs by 3D echocardiography is a technically challenging method. One crucial step is the collection of images. Three individual transducer positions are necessary to visualize the important structures; these are the left lateral ridge, the ostium of the PVs and the intervenous ridge of the left and right PVs. Next, 3D images are acquired and saved as digital loops. These datasets are cropped, which result in the en face views displaying spatial relationships. This step can also be employed to determine the anatomical variations of the PVs. Finally, multiplanar reconstructions are created to measure each individual parameter of the PVs. Optimal quality and orientation of the acquired images are paramount for the appropriate assessment of PV anatomy. In the present work, we examined the 3D visibility of the PVs and the suitability of the above method in 80 patients. The aim was to provide a detailed outline of the essential steps and potential pitfalls of PV visualization and assessment with 3D echocardiography.

Raising the Digital Profile of Facial Palsy: National Surveys of Patients' and Clinicians' Experiences of Changing UK Treatment Pathways and Views on the Future Role of Digital Technology.

BackgroundFacial nerve palsy leaves people unable to move muscles on the affected side of their face. Challenges exist in patients accessing facial neuromuscular retraining (NMR), a therapy used to strengthen muscle and improve nerve function. Access to therapy could potentially be improved through the use of digital technology. However, there is limited research available on patients’ and clinicians’ views about the potential benefits of such telerehabilitation based on their lived experiences of treatment pathways.ObjectiveThis study aims to gather information about facial palsy treatment pathways in the United Kingdom, barriers to accessing NMR, factors influencing patient adherence, measures used to monitor recovery, and the potential value of emerging wearable digital technology.MethodsSeparate surveys of patients with facial palsy and facial therapy specialists were conducted. Questionnaires explored treatment pathways and views on telerehabilitation, were co-designed with users, and followed a similar format to enable cross-referencing of responses. A follow-up survey of national specialists investigated methods used to monitor recovery in greater detail. Analysis of quantitative data was conducted allowing for data distribution. Open-text responses were analyzed using thematic content analysis.ResultsA total of 216 patients with facial palsy and 25 specialist therapists completed the national surveys. Significant variations were observed in individual treatment pathways. Patients reported an average of 3.27 (SD 1.60) different treatments provided by various specialists, but multidisciplinary team reviews were rare. For patients diagnosed most recently, there was evidence of more rapid initial prescribing of corticosteroids (prednisolone) and earlier referral for NMR therapy. Barriers to NMR referral included difficulties accessing funding, shortage of specialist therapists, and limited awareness of NMR among general practitioners. Patients traveled long distances to reach an NMR specialist center; 9% (8/93) of adults reported traveling ≥115 miles. The thematic content analysis demonstrates positive attitudes to the introduction of digital technology, with similar incentives and barriers identified by both patients and clinicians. The follow-up survey of 28 specialists uncovered variations in the measures currently used to monitor recovery and no agreed definitions of a clinically significant change for any of these. The main barriers to NMR adherence identified by patients and therapists could all be addressed by using suitable real-time digital technology.ConclusionsThe study findings provide valuable information on facial palsy treatment pathways and views on the future introduction of digital technology. Possible ways in which emerging sensor-based digital technology can improve rehabilitation and provide more rigorous evidence on effectiveness are described. It is suggested that one legacy of the COVID-19 pandemic will be lower organizational barriers to this introduction of digital technology to assist NMR delivery, especially if cost-effectiveness can be demonstrated.

Early Follow-Up of Arthroscopic Latarjet Procedure with Screw or Suture-Button Fixation for Recurrent Anterior Shoulder Instability.

ObjectiveTo evaluate the early clinical and radiographic results of arthroscopic Latarjet procedure using screw or suture‐button fixation in patients with recurrent anterior shoulder dislocation.MethodsTwelve patients who underwent arthroscopic Latarjet procedure between January 2015 and December 2018 at our institution were retrospectively studied. Data of the patients' history, including age, gender, side of affected arm, body mass index (BMI), and the number of dislocations since fist dislocation were collected. Preoperative and postoperative clinical follow‐up data were evaluated using Walch–Duplay score, American Shoulder and Elbow Society (ASES) score, and modified Rowe score. Active external rotation and active internal rotation at 90° of abduction as well as active elevation were evaluated preoperatively and postoperatively. The position and healing condition of the transferred coracoid bony graft were also assessed using computed tomography (CT) and Mimics 19.0 software.ResultsMean follow‐up was 24.9 months (range, 13 to 53 months) of all patients. At final follow‐up, the average ASES score (preoperative vs postoperative values) had improved from 68.9 ± 7.9 to 91.1 ± 6.1 in screw fixation group and 68.9 ± 8.9 to 87.5 ± 6.7 in suture‐button fixation group; the average Rowe score (preoperative vs postoperative values) had improved from 25.0 ± 8.4 to 92.5 ± 4.2 in screw fixation group and 21.7 ± 13.7 to 93.3 ± 4.1 in suture‐button fixation group; the average of Walch–Duplay score (preoperative vs postoperative values) had improved from 12.5 ± 15.1 to 91.7 ± 4.1 in screw fixation group and 18.3 ± 20.7 to 88.3 ± 7.5 in button fixation group. The forward flexion was 175.0° ± 8.4° preoperatively and 178.3° ± 4.1° postoperatively in screw fixation group while 174.8° ± 10.2° preoperatively and 175.0° ± 5.5° postoperatively in suture‐button fixation group. The active external rotation was 77.5° ± 5.2° preoperatively and 71.7° ± 4.1° postoperatively in screw fixation group while 72.5° ± 6.9° preoperatively and 68.3° ± 7.5° postoperatively in suture‐button fixation group. The average of active internal rotation was 66.7° ± 6.1° preoperatively and 67.5° ± 6.1° postoperatively in screw fixation group while 68.3° ± 11.3° preoperatively and 66.7° ± 7.5° postoperatively in suture‐button fixation group. In postoperative CT scan, 91.7% grafts midline center were located at or under the equator in the en face view; 75% of the bone blocks were flush to the glenoid face in the axial view, with only two grafts exhibiting slight medial placement in screw fixation group (33.3%) and one graft exhibiting slight lateral placement in suture‐button fixation group (16.7%). All grafts achieved bone union. Graft absorption mostly occurred outside of the “best‐fit” circle. The average bony absorption rates of the coracoid grafts were 25.2% and 10.18% in screw fixation group and suture‐button fixation group, respectively, at 6 months postoperative follow‐up.ConclusionBoth suture‐button fixation and screw fixation techniques in arthroscopic Latarjet procedure revealed excellent clinical outcomes with low complication rates in the early follow‐up. The suture‐button fixation exhibited a flexible fixation pattern that allowed for self‐correction to some extent, even slight lateralization could finally remodel over time.

Semi-Supervised Face Frontalization in the Wild

Synthesizing a frontal view face from a single nonfrontal image, i.e. face frontalization, is a task of practical importance in a wide range of facial image analysis applications. However, to train the frontalization model in a supervised manner, most existing face frontalization methods rely on the availability of nonfrontal-frontal face pairs (typically from the Multi-PIE dataset) captured in a constrained environment. Such approaches, in return, limit the generalizability of their application to unconstrained scenarios. Unfortunately, although a large amount of in-the-wild face datasets are available, they cannot easily be utilized for face frontalization training since the nonfrontal and frontal facial images are not paired. To train a frontalization network which generalizes well to both constrained and unconstrained environments, we propose a semi-supervised learning framework which effectively uses both (labeled) indoor and (unlabeled) outdoor faces. Specifically, to achieve this goal, this article presents a Cycle-Consistent Face Frontalization Generative Adversarial Network (CCFF-GAN) which consists of both (1) the supervised and (2) the unsupervised components. For (1), we use the indoor paired (labeled) data to learn a roughly accurate frontalization network which may not generalize well to outdoor (in-the-wild) scenarios. For (2), to cope with the generalization issue, the unsupervised part uses the unpaired (unlabeled) images under the perceptual cycle consistency constraint in the semantic feature space to generalize the network from controlled (indoor) to uncontrolled (outdoor) environment. Extensive experiments demonstrate the effectiveness of the proposed method in comparison with the state-of-the-art face frontalization methods, especially under the in-the-wild scenarios.

Coprinellus ovatus sp. nov. from Pakistan

A Coprinellus specimen collected in Islamabad, Pakistan, showed characters that were distinct from those of all other Coprinellus spp.: an ovoid shaped pileus; a caespitose stipe base; utriform cheilocystidia bearing crystals; a pileipellis of loosely arranged clavate to mucronate hyphae; and basidiospores (9.5–11.6 × 6.0–7.8 × 5.6–6.2 μm) with shapes ranging from mitriform or triangular to ellipsoid in face view, amygdaliform to ellipsoid in side view. Combination of all these characters and molecular analysis of ITS sequences support its identification as a new species.

Evaluation of influence factors on the width, length, and width to length ratio of the maxillary central incisor: A systematic review and meta-analysis.

The aim of this study was to analyze whether symmetry of left and right sides, gender, measuring method, and ethnicity have influences on width (W), length (L), and width to length ratio (W/L) of the maxillary central incisor (MCI) and provide a reference for dental treatment planning in the esthetic zone. An electronic search was conduct of the dental literature. Studies reporting data about measurements were included. Data were extracted and analyzed for the differences between left and right, male and female, different measuring methods, and ethnicities by Review Manager and Stata statistical software. Seventeen studies were included. There were no differences between measurement of the left and right groups, perceived and actual measuring groups. However, differences were found between genders in MCI's W and L but no difference in W/L. Differences were also found between Asians and Caucasian subjects in MCI's W, L, and W/L. The results of this meta-analysis suggest that symmetry of left and right sides and measuring method do not influence MCI dimension. Gender and ethnicity are found as influence factors for MCI dimension. We believe these findings can be helpful for dentists to decide and design the dimensions of the restorations for maxillary anterior teeth in clinical practices. In the process of designing maxillary anterior teeth for implantation, the contralateral MCI can be helpful to create a symmetrical esthetic restoration. For patients with maxillary anterior tooth loss or diastemas, dentists should divide the left and right space equally and keep the MCI contact area aligned with the midline. Dentists should take face size and gender into consideration when making treatment plans for the MCI. Facial parameters as well as the size ratios of the previous teeth can be evaluated and may influence the size and shape of the teeth. When measuring anterior teeth or facial dimensions for esthetic evaluation, the recommended method is to measure the perceived sizes of a facial view image created by a digital camera. Slight discrepancies may exist between the actual and measured values due to the curvature of the arch and the angle in which the photograph was taken.

Gender Gap in Science

Abstract There continues to be a persistent gap between women’s and men’s participation, access, rights, pay, and benefits in the natural sciences, mathematics, and computing. The UNESCO Institute of Statistics reports that fewer than 30% of the world’s researchers are women. Many scientists, mathematicians, computing experts, and policy makers are working to reduce this gender gap by way of a wide range of initiatives. The International Science Council (ISC) funded a unique three-year project in 2017-2019 called, “A Global Approach to the Gender Gap in Mathematical, Computing and Natural Sciences: How to measure it, how to reduce it?” that has provided a wide-ranging view of the issues women face in the sciences and how these issues may be overcome.

3D face reconstruction from mugshots: Application to arbitrary view face recognition

Mugshots while routinely acquired by law enforcement agencies are under utilized by automated face recognition systems. In this paper, we propose a regression based approach to reconstruct textured full 3D face models from multi-view mugshot images. Using landmarks from the input frontal and profile mugshots of a subject, our method reconstructs his⧹her 3D face shape via either linear or nonlinear regressors. The texture of the mugshot images is mapped to the reconstructed 3D face shape via an efficient seamless texture recovery scheme. Compared with existing 3D face reconstruction methods, the proposed method more effectively utilizes the three-view mugshot face images collected during booking. The reconstructed 3D faces are used to generate realistic multi-view face images to enlarge the gallery and facilitate arbitrary view face recognition. Evaluation experiments have been done on BFM and Bosphorus databases in terms of reconstruction accuracy, and on Multi-PIE and Color FERET databases in terms of recognition accuracy. The results show that the proposed method can reduce the 3D face reconstruction error of the best competitive method from 2.31 mm to 1.88 mm, and improve the recognition accuracy of state-of-the-art deep learning based face matchers by as much as ~4% on Multi-PIE and ~2% on Color FERET despite the high baseline set by them.

Additional cleft mitral valve diagnosed by a combination of 2-D and 3-D echocardiography using transesophageal echocardiography during mitral valve prolapse: a case report

BackgroundA mitral cleft may be an important etiological factor for significant mitral regurgitation. We diagnose an additional cleft mitral valve by a combination of 2-dimensional (2-D) and 3-dimensional (3-D) echocardiography.Case presentationWe describe the case of a severe mitral regurgitation due to posterior leaflet prolapse (P2). In the 2-D view, which is obtained after turning the probe clockwise from the mid-esophageal long-axis view, TEE showed a moderate central regurgitation jet. In the 3-D en face view, a cleft between P2 and P3 was identified, and we found that the cause of mitral regurgitation was not only P2 prolapse but also a cleft between P2 and P3.ConclusionA complex mitral valve lesion was detected by a combination of 2-D and 3-D TEE. The presence of a cleft could affect the surgical procedure because of the possibility that an enlarged cleft would increase with leaflet resection.

Species diversity of ring nematodes of the genus Criconemoides (Nematoda: Criconematidae) based on three new species from China, using integrative taxonomy

Ring nematodes of the genus Criconemoides are a group of polyphagous, migratory root-ectoparasites of plants. In a nematological survey of Zhejiang Province, three new Criconemoides species were isolated from the rhizosphere of Citrus sp., Euonymus alatus and Pterocarya stenoptera trees. In the present study, the new species characterized using an integrative taxonomic approach and described as Criconemoides parainformis n. sp., C. geraerti n. sp. and C. rotundicaudatus n. sp. Three of the species shares truncated anteriorly flattened lip region comprised of two annuli, body annuli margin smooth with few anastomoses, (except C. rotundicaudatus n. sp. it has crenated annuli margins and numerous anastomoses), excretory pore 1–2 annuli posterior to pharyngeal bulb base, (except C. geraerti n. sp. it has excretory pore at the same level, or 1–2 annuli anterior to pharyngeal bulb base), vulva closed, anus hardly visible 1–3 annuli posterior to vulva. The new species can be distinguished based on their en face view pattern under scanning electron microscope (SEM) and the tail shapes. i.e. C. parainformis n. sp. has an ellipsoid oral disc, slightly fused pseudolips and tail ending in a bilobed terminus. C. geraerti n. sp. has a hexagonal oral disc, separated pseudolips, and a bluntly conoid tail. C. rotundicaudatus n. sp. has a rounded oral disc, well developed pseudolips, and a short broadly rounded tail. Besides detailed morphological studies using SEM, genomic and mitochondrial molecular data were obtained for the three described new species. In inferred phylogenies, these three species clustered with known Criconemoides species in 18S, 28S, ITS and coxI trees. Currently, only four known Criconemoides species occur in China and the discovery of the three new Criconemoides species in present study has increased our knowledge on the diversity of Criconemoides in China.

Evaluation of Facial and Dental Midline Discrepancies in Nepalese Population

Introduction: The facial midline is defined by the landmark such as the nose, philtrum, and chin aligned in a straight line. It should be in the center of the face and should coincide with the dental midline. But clinically it is often observed that some discrepancies exist between facial and dental midlines. Thus the aim of this study was to evaluate the facial and dental midline discrepancies.&#x0D; Methods: A total of 300 subjects, 150 male and 150 female from People’s Dental College and Hospital were selected. Full facial view standardized photograph with a posed smile with teeth in occlusion was taken with Canon 400D digital SLR. For standardized measurement vertical metallic scale with millimeter, markings were placed on the right side of the patient in all cases. The software program Digimizer image analysis (version 4.6.1) was used to determine the facial and maxillary dental midline.&#x0D; Result: This study showed 6.66% of male and 12% of female had perfectly coinciding F1 facial midline (perpendicular from the midpoint of inner canthus distance), F2 facial midline (line joining the midpoint of inner canthus and the midpoint of the base of the nose) and maxillary midline. 26% of males and 28% of females had less than 1mm of the discrepancy of F1 midline to maxillary midline whereas 41% of males and 38% of females had less than 1 mm of a discrepancy between F2 facial midline and maxillary midline. The study also showed that 24% of males and 24.66% of females had none coincidence of any of the midlines with one another.&#x0D; Conclusion: Most of the Nepalese have noncoinciding facial and dental midline but females have more coinciding midlines in comparison to males. The shifted facial midlines are more towards the left side in relation to maxillary dental midline.

Evaluation of Divine Proportions in Face and Smile of Patients With Unilateral Cleft Lip and Palate.

The facial view of patients with cleft lip and palate greatly affects their psychological well-being and usually leads to introspection. The aim of this study was to compare the face and smile of cleft lip and palate patients and normal population with divine proportion. In this retrospective study, 20 female patients (14-25 years) with unilateral cleft lip and palate, who referred to Orthodontic Department of Mashhad School of Dentistry, were selected. The control group consisted of 10 normal female persons with ideal face and normal occlusion. After scanning photographs of full face, profile, and smile views of them, the divine proportions were measured by Photoshop software. Then the data were entered into SPSS software version 22 and analyzed using 2 sample independent t test. P value less than 0.05 were considered as significant. In the study group all proportions were significantly less than the golden proportion. Ls-Rcus/Rch-Rcus and Ls-Lcus/Lch-Lcus had the least difference and Sn-Sm/N-Sn and Sn-Sm/Sm-Me had the most. In the control group, all proportions except Ls-Lcus/Lch-Lcus and Ls-Rcus/Rch-Rcus, were less than the golden proportion. Sn-Sm/N-Sn had the most difference and N-Sn/Sm-Me had the least.Approximately all proportions in cleft patients were significantly different from normal population. Ls-Lcus/Lch-Lcus had the highest difference between study and control group; however, Tr-Sn/Tr-Me in both groups were equal. The differences between facial indices in cleft lip and palate patients, normal people and golden proportion were significant. As facial proportions of normal people in the authors' study were also different from divine proportions, the authors can conclude that to reach acceptable esthetic results, the authors can approximate patients to normal populations. Unfortunately, the patients with large bone defects, cannot reach to the "esthetic" divine proportion even after reconstructive surgery.

The Social Perception of Microtia and Auricular Reconstruction.

To examine the social perception of microtia and quantify the effect of reconstruction on socially perceived attributes. Parental consent was obtained for peri-reconstruction photographs in a patient with unilateral grade 3 microtia without an underlying craniofacial syndrome. With computer simulation, the normal, preoperative microtia, and postoperative reconstruction ear were isolated and blended into the oblique and lateral views of that volunteer's face to isolate ear morphology as a variable against a constant facial baseline. These photographs were embedded into Web-based surveys with visual analogue scales to capture social perception data and then were sourced to general population adults. Survey respondents totaled 631. On average, the face with the microtia ear was perceived to be less friendly (P = .015), less healthy (P = .022), and less successful (P = .005) than the same face with the "normal" ear. There were no statistically significant differences in socially perceived attributes between the face with the normal ear and the face with the reconstructed ear. This is the first study to examine the social perception consequences of microtia and microtia reconstruction in children. These findings may explain the significant psychosocial distress experienced by these patients by exploring the social perception of specific attributes perceived. Lastly, this study may better inform microtia patients and their physicians on the impact of auricular reconstruction on third party's perception of social attributes. N/A Laryngoscope, 131:195-200, 2021.

Normal Gaze Patterns of the Face in Lateral View.

Importance: Current efforts to quantify the attentional distraction of facial deformities have been limited to deformities that are best perceived when the face is in frontal view, and there remains a paucity of knowledge of societal perception of the face in lateral view. To date, no attempts have been made to characterize the fixation patterns of the face in lateral view. Objective: To characterize the fixation patterns and gaze patterns of the face in lateral view. Design, Setting, and Participants: This was a prospective randomized controlled trial at an academic tertiary medical center. Eighty participants (mean age 23.6 ± 1.7 years, 52.5% female) gazed freely at 11 images of faces in lateral view for 10 s each as an infrared eye-tracker recorded eye movements in real time. Main Outcomes and Measures: Recorded eye movements are superimposed on the images to visualize areas of interest (AOIs) that attract the most attention. Fixation duration targeted at each AOI is transformed into relative fixation of the entire face and neck. Hotelling's test of variance followed by post hoc t-testing assessed for the significance of fixation differences between the mouth and cheeks. Results: Participants spent an average of 6.0 (95% CI 5.8-6.2) s gazing at the face and neck areas of each image. Of this attention, 2.8 s or 49.8% (45.4-54.2%) was directed toward the eye, followed distantly by the nose (mean, 95% CI) (16.4%, 14.5-18.3%), cheek (12.0%, 11.4-14.5%), neck (4.6%, 3.8-5.4%), and mouth (4.0%, 3.4-4.6%). These differences were found to be significant by Hotelling's analysis and post hoc testing. A student's t-test also indicated observers directed significantly more attention within the eye-nose-cheek triangle [4.6 s or 79.5% (75.6-83.5)] compared with the eye-nose-mouth triangle [4.1 s or 71.2% (66.9-75.5)] (p < 0.001). Conclusions and Relevance: When perceiving novel faces in lateral view, casual observers preferentially directed attention toward the eye, nose, and cheek. These findings suggest that we draw from a slightly different collection of features to build a schema of the sagittal face, which may serve to complement the central triangle and build upon a three-dimensional model of the "normal" human face. Level of Evidence: NA.