• Archives of Plastic Surgery
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• v.49 no.5
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• pp.633-641
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• 2022

Introduction In chronic facial palsy, synkinetic muscle overactivity and shortening causes muscle stiffness resulting in reduced movement and functional activity. This article studies the role of multimodal therapy in improving outcomes. Methods Seventy-five facial palsy patients completed facial rehabilitation before being successfully discharged by the facial therapy team. The cohort was divided into four subgroups depending on the time of initial attendance post-onset. The requirement for facial therapy, chemodenervation, or surgery was assessed with East Grinstead Grade of Stiffness (EGGS). Outcomes were measured using the Facial Grading Scale (FGS), Facial Disability Index, House-Brackmann scores, and the Facial Clinimetric Evaluation scale. Results FGS composite scores significantly improved posttherapy (mean-standard deviation, 60.13 ± 23.24 vs. 79.9 ± 13.01; confidence interval, -24.51 to -14.66, p < 0.0001). Analysis of FGS subsets showed that synkinesis also reduced significantly (p < 0.0001). Increasingly, late clinical presentations were associated with patients requiring longer durations of chemodenervation treatment (p < 0.01), more chemodenervation episodes (p < 0.01), increased doses of botulinum toxin (p < 0.001), and having higher EGGS score (p < 0.001). Conclusions This study shows that multimodal facial rehabilitation in the management of facial palsy is effective, even in patients with chronically neglected synkinesis. In terms of the latency periods between facial palsy onset and treatment initiation, patients presenting later than 2 years were still responsive to multimodal treatment albeit to a lesser extent, which we postulate is due to increasing muscle contracture within their facial muscles.

• Archives of Plastic Surgery
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• v.48 no.3
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• pp.269-277
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• 2021

Background The Sunnybrook facial grading scale is a comprehensive scale for the evaluation of facial paralysis patients. Its results greatly depend on subjective input. This study aimed to develop and validate an automated Sunnybrook facial grading scale (SBface) to more objectively assess disfigurement due to facial paralysis. Methods An application compatible with iOS version 11.0 and up was developed. The software automatically detected facial features in standardized photographs and generated scores following the Sunnybrook facial grading scale. Photographic data from 30 unilateral facial paralysis patients were randomly sampled for validation. Intrarater reliability was tested by conducting two identical tests at a 2-week interval. Interrater reliability was tested between the software and three facial nerve clinicians. Results A beta version of the SBface application was tested. Intrarater reliability showed excellent congruence between the two tests. Moderate to strong positive correlations were found between the software and an otolaryngologist, including the total scores of the three individual software domains and composite scores. However, 74.4% (29/39) of the subdomain items showed low to zero correlation with the human raters (κ<0.2). The correlations between the human raters showed good congruence for most of the total and composite scores, with 10.3% (4/39) of the subdomain items failing to correspond (κ<0.2). Conclusions The SBface application is efficient and accurate for evaluating the degree of facial paralysis based on the Sunnybrook facial grading scale. However, correlations of the software-derived results with those of human raters are limited by the software algorithm and the raters' inconsistency.

• Journal of KIISE:Software and Applications
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• v.27 no.6
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• pp.618-631
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• 2000

In this paper, we suggest the method of 3D facial synthesis using the motion of 2D facial images. We use the optical flow-based method for estimation of motion. We extract parameterized motion vectors using optical flow between two adjacent image sequences in order to estimate the facial features and the facial motion in 2D image sequences. Then, we combine parameters of the parameterized motion vectors and estimate facial motion information. We use the parameterized vector model according to the facial features. Our motion vector models are eye area, lip-eyebrow area, and face area. Combining 2D facial motion information with 3D facial model action unit, we synthesize the 3D facial model.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.35.1-35.6
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• 2020

Background: Miescher's cheilitis granulomatosa (MCG) is a rare chronic inflammatory disease and is known as the monosymptomatic clinical form of Melkersson-Rosenthal syndrome (MRS). It is characterised by swelling of one or both lips and more frequently affects the upper lip. Histopathological findings show the presence of numerous inflammatory infiltrates and granuloma formations. Pharmacological treatments and surgery have provided results that are positive yet insufficiently stable in the long term. The clinical case described is of a 68-year-old female patient with a diagnosis of MCG of the upper lip. Case presentation: The patient was diagnosed and treated at the Oral Medicine and Oral Pathology outpatient clinic of Maxillofacial and Odontostomatology Unit, Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico. The patient was recommended localised treatments of photobiomodulation (PBM) using a diode laser with a 635 nm and 980 nm dual-wavelength (λ) approach, a 600-micron fibre, and a handpiece with a 1-cm-diameter lens at 300 mW. Three treatments a week were administered for four weeks for a total of 12 treatment sessions (T₁-T₁₂). After that, the patient had a long follow-up period of about 2 years. The therapeutic results were clear from the initial stages of treatment. There was an immediate, gradual, and consistent reduction in labial swelling. A reduction in the size of the lip by about 35% at T₁₀-T₁₂ was observed, returning the size and volume of the upper lip within the normal clinical range. The painful symptoms subsided after the seventh treatment (T₇). The histopathological check at 3 months and the follow-up in particular confirmed the disease was in remission with satisfactorily stable treatment results. Moreover, the patient did not use any other treatments on the area from the early laser treatments through to the end of the follow-up period. Conclusions: Our experience describes a clinical case of MCG treated with PBM and effectively resolved with a reduction of the lip swelling. The real success of the treatment emerged over time, showing that the tissue healing was stable. In absence of any collateral phenomena, this confirms the effective and documented therapeutic potential of PBM for chronic inflammatory infiltrates.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.13 no.11
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• pp.5546-5559
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• 2019

Facial action units (AUs) have recently drawn increased attention because they can be used to recognize facial expressions. A variety of methods have been designed for frontal-view AU detection, but few have been able to handle multi-view face images. In this paper we propose a method for multi-view facial AU detection using a fused multilayer, multi-task, and multi-label deep learning network. The network can complete two tasks: AU detection and facial view detection. AU detection is a multi-label problem and facial view detection is a single-label problem. A residual network and multilayer fusion are applied to obtain more representative features. Our method is effective and performs well. The F1 score on FERA 2017 is 13.1% higher than the baseline. The facial view recognition accuracy is 0.991. This shows that our multi-task, multi-label model could achieve good performance on the two tasks.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.2.1-2.9
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• 2016

Background: We reviewed the biological and mechanical properties of porous hydroxyapatite (HA) compared to other synthetic materials. Computer-aided design/computer-aided manufacturing (CAD/CAM) was also evaluated to estimate its efficacy with clinical and radiological assessments. Method: A systematic search of the electronic literature database of the National Library of Medicine (PubMed-MEDLINE) was performed for articles published in English between January 1985 and September 2013. The inclusion criteria were (1) histological evaluation of the biocompatibility and osteoconductivity of porous HA in vivo and in vitro, (2) evaluation of the mechanical properties of HA in relation to its porosity, (3) comparison of the biological and mechanical properties between several biomaterials, and (4) clinical and radiological evaluation of the precision of CAD/CAM techniques. Results: HA had excellent osteoconductivity and biocompatibility in vitro and in vivo compared to other biomaterials. HA grafts are suitable for milling and finishing, depending on the design. In computed tomography, porous HA is a more resorbable and more osteoconductive material than dense HA; however, its strength decreases exponentially with an increase in porosity. Conclusions: Mechanical tests showed that HA scaffolds with pore diameters ranging from 400 to $1200{\mu}m$ had compressive moduli and strength within the range of the human craniofacial trabecular bone. In conclusion, using CAD/CAM techniques for preparing HA scaffolds may increase graft stability and reduce surgical operating time.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.5
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• pp.1057-1061
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• 2008

For the purpose of investigating the reasonable logics contained in physiognomy of east and old western medicine. hypothetical researches based on hydromechanics theory were performed concerning facial types of form and pathologic features, especially 4 types of Dr. Jisan-Essence, Qi energy. Emotional Activity and Blood(EQAB). In order to infer the functional relation between facial type forming and EQAB factors, EQAB were supposed as fluid grounded on their continual flowing or periodical change and pressure effect from its congestion. and a premise that there's a linear corresponding relationship between the appearance of organ and its physical conditions of its inner vessels is formed too. Through this work, the unit fluid model(UFM) of Essence can be assumed as circle shape formed by the high viscosity and surface tension, the UFM model of Qi energy as quadrangular shape by the scattering features to outer four directions, and the UFM of emotional activity as inverted triangular shape by the flippant and uprising features, and the UFM of blood as ellipsoid triangle by the heavy and descending features in spite of circulation. The shapes made from each UFM are reproduced in the process of human development and manifest respective facial shape through the self-reproduction method like fractal theory in the last. Conclusively. it is said that the facial form analysis method like EQAB type theory can be the useful methodology to understand the human pathological and physiological features in view of hydromechanics.

• Journal of the Korea Society of Computer and Information
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• v.10 no.3 s.35
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• pp.55-64
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• 2005

The avatar can be used as an auxiliary methodology of text and image communications in cyber space. An intelligent communication method can also be utilized to achieve real-time communication, where intelligently coded data (joint angles for arm gestures and action units for facial emotions) are transmitted instead of real or compressed pictures. In this paper. for supporting the action of arm and leg gestures, a method of generating the facial expressions that can represent sender's emotions is provided. The facial expression can be represented by Action Unit(AU), in this paper we suggest the methodology of finding appropriate AUs in avatar models that have various shape and structure. And, to maximize the efficiency of emotional expressions, a comic-style facial model having only eyebrows, eyes, nose, and mouth is employed. Then generation of facial emotion animation with the parameters is also investigated.

• Journal of the Korean Institute of Intelligent Systems
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• v.21 no.3
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• pp.395-400
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• 2011

In this paper, we propose an study of the facial emotion recognition considering the dynamical variation of emotional state in facial image sequences. The proposed system consists of two main step: facial image based emotional feature extraction and emotional state classification/recognition. At first, we propose a method for extracting and analyzing the emotional feature region using a combination of Active Shape Model (ASM) and Facial Action Units (FAUs). And then, it is proposed that emotional state classification and recognition method based on Hidden Markov Model (HMM) type of dynamic Bayesian network. Also, we adopt a Harmony Search (HS) algorithm based heuristic optimization procedure in a parameter learning of HMM in order to classify the emotional state more accurately. By using all these methods, we construct the emotion recognition system based on variations of the dynamic facial image sequence and make an attempt at improvement of the recognition performance.

• Archives of Plastic Surgery
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• v.35 no.4
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• pp.419-422
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• 2008

Purpose: Absorbable bone fixation materials for operation of facial bone fracture are composed of poly- lactic acid(PLA) & poly-glycolic acid(PGA). These materials are absorbed after facial bone healing period. Therefore, these materials are harmless in human body. But because of it's radioopacity, the number and the location of the materials are not checked in follow-up X-ray examination. We studied absorbable bone fixation materials checked radiological examination. So, we made the absorbable plate composed of PLA, Hydroxyapatite (HA) and Gold(Au). Methods: Plate 1 was consisted of pure PLA. Plate 2 was consisted of PLA(50%) and HA(50%). Plate 3 - 7 were consisted of PLA(50%), and variable composition of HA & Au. The ratio of Au was as following. From the plate 3 to plate 7, the Au ratio was 1%, 5%, 10%, 17%, and 25%, respectively. Total 3 examinations were used-naked eye examination, simple X-ray examination, and Haunsfield unit of plate in CT examination. Results: Naked eye examination found out that the color of plate 1 was most white. As the Au ratio increases, the color of plate was getting close to khaki color. the radioopacity of plate 2 was similar cortical bone of face in simple X-ray. The Haunsfield unit of cortical bone of face was 1000 HU. Haunsfield unit of titanium plate was 2900 HU. Haunsfield unit of plate 1 through plate 7 were -242, 1489, 1776, 3052, 3092, 3095, and 3095, respectively. Conclusion: Radioopacity of plate 2 was similar to cortical bone of face. In CT examination, Hanusfield unit of plate 2 was similar to Hanusfield unit of cortical bone of face. Hanusfield unit of plate 4 - 7 were similar to Hanusfield unit of titanium plate. So to trace bone fixation materials after facial bone surgery, the best ratio of Au is about 1 - 5%. If this study is applied to facial bone surgery, radiologic follow up would be easy after facial bone surgery.