Function and Form Outcomes in Patients with Facial Paralysis

面瘫患者的功能和形态结果

• 批准号: 9112044
• 负责人: CARROLL ANN TROTMAN
• 金额: $ 25.96万
• 依托单位: TUFTS UNIVERSITY BOSTON
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-04 至 2018-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9112044
• 关键词: Acute; Affect; Age; Antiviral Agents; Appearance; Area; Autoimmune Diseases; Behavior; Bell Palsy; Benign; Chronic; Clinical; Clinical assessments; Commissure; Contracture; Devices; Diagnosis; Dimensions; Disability Evaluation; Ear Diseases; Ectropion; Elements; Emergency department visit; Emotional; Esthetics; Evaluation; Eye; Face; Facial asymmetry; Facial nerve structure; Facial paralysis; Fees; Frequencies; Future; Future Generations; Goals; Health; Health Care Costs; Housing; Image; Impairment; Intervention; Joints; Left; Legal patent; Magnetic Resonance Imaging; Malignant Neoplasms; Matched Group; Measurement; Measures; Methods; Movement; Muscle; Nerve; Observational Study; Operative Surgical Procedures; Oral; Outcome; Paralysed; Participant; Patients; Perception; Peripheral; Pharmaceutical Preparations; Physical therapy; Process; Ptosis; Qualitative Methods; Quality of life; Recovery; Rehabilitation therapy; Research; Severities; Side; Smiling; Steroids; Surgeon; Syndrome; System; Testing; Time; Trauma; United States; United States National Institutes of Health; age group; base; cleft lip and palate; disability; novel; patient population; prospective; reconstruction; sex; social; soft tissue; treatment planning

 DESCRIPTION (provided by applicant): Patients with facial paralysis have an obvious facial disability including facial disfigurement and impairment in soft tissue movements, particularly in facial expressive behaviors. These negative physical sequelae not only impact facial esthetics and function, but also patients' social and emotional quality of life (QOL). Treatments range from non-surgical interventions and facial reanimation surgery to new implantable facial pacing devices that would potentially initiate artificial movement on the paralyzed side of the face. Traditionally, surgeons' plan treatment based on isolated measurements made from 2D photographs and subjective grading of the patient's face, both of which are limited in scope and dimension. Our research has demonstrated the utility of novel, landmark-based, 3D dynamic and static quantitative (objective) measures for the evaluation of facial soft tissue function (NIH DE 013814, DE 016964, and DE 013814-08S1). These measures have been validated for use in the cleft lip/palate (CL/P) patient population. The measures are objective and quantitative. They provide a more precise diagnosis of facial soft tissue disability and evaluation of surgical outcomes. The main goal of this prospective, observational study is to determine the applicability of these novel 3D dynamic and static measures for quantification and measurement of impairment and disfigurement, as well as change over time, in patients with facial paralysis. We will also explore the utility of non-landmark based dynamic and static measures. The global research question is whether the use of the measures will provide a more comprehensive analysis of the severity of facial paralysis and the changes over time (recovery) when compared with current assessment methods. The specific aims of the study are: Specific Aim 1. To quantitatively evaluate the range of facial soft tissue disability (facial impairment and disfigurement) in patients with acute, unilateral, flaccid facial paralysis and track the changes over time (3 month recovery period), and to compare the facial disability in the patients with a group of age- and sex-frequency matched normal subjects. Specific Aim 2. In patients with acute unilateral, flaccid facial paralysis, to compare the current qualitative clinical assessment methods for facial impairment and disfigurement (House-Brackman Facial Nerve Grading System & Sunnybrook Facial Grading System ) with the objective quantitative assessments in order to assess the differential information provided by a quantitative zonal analysis versus a qualitative global assessment. Specific Aim 3. (a) To assess perceptions of facial appearance and QOL over time in patients with acute, unilateral, flaccid facial paralysis and to compare these perceptions with those of control subjects, and (b) To correlate the patients' perceptions over time with the quantitative measures of facial disability. Ultimately, this study is unique for the rehabilitation of patients with facial paralysis in that the focus is on generating novel, objective, 3D measures to characterize the condition and temporal changes, and on the generation of future hypotheses to optimize interventions and assess the outcomes of the different treatments.

 描述（申请人提供）：面瘫患者有明显的面部残疾，包括面部毁容和软组织运动障碍，特别是面部表达行为。这些负面的身体后遗症不仅影响面部美观和功能，还影响患者的社交和情感生活质量（QOL）。治疗范围从非手术干预和面部复活手术到新的植入式面部起搏设备，这些设备可能会在面部瘫痪的一侧启动人工运动。传统上，外科医生的计划治疗基于从2D照片和患者面部的主观分级进行的孤立测量，这两者在范围和尺寸上都是有限的。我们的研究已经证明了新的，基于标志的，3D动态和静态定量（客观）措施的面部软组织功能（NIH）评价的实用性 DE 013814、DE 016964和DE 013814- 08 S1）。这些措施已经过验证，可用于唇腭裂（CL/P）患者人群。这些措施是客观和量化的。他们提供了一个更精确的面部软组织残疾的诊断和手术结果的评估。这项前瞻性观察性研究的主要目标是确定这些新型3D动态和静态测量方法在面瘫患者中对损伤和毁容以及随时间变化的量化和测量的适用性。我们还将探讨非地标为基础的动态和静态措施的效用。全球研究的问题是，与目前的评估方法相比，使用这些措施是否能更全面地分析面瘫的严重程度和随时间的变化（恢复）。研究的具体目标是：具体目标1。定量评价急性单侧弛缓性面瘫患者面部软组织功能障碍（面部损伤和毁容）的范围，并追踪其随时间（3个月恢复期）的变化，并与一组年龄、性别频率匹配的正常人进行比较。具体目标2。在急性单侧弛缓性面瘫患者中，比较目前面部损伤和毁容的定性临床评估方法（House-Brackman面神经分级系统和Sunnybrook面部分级系统）与客观定量评估，以评估定量区域分析与定性整体评估提供的差异信息。具体目标3。(a)评估急性单侧弛缓性面瘫患者随时间对面部外观和QOL的感知，并将这些感知与对照受试者的感知进行比较，以及（B）将患者随时间的感知与面部残疾的定量测量相关联。最终，这项研究是独一无二的， 面瘫患者的康复，重点是生成新的，客观的，3D测量来表征病情和时间变化，以及生成未来的假设来优化干预措施和评估不同治疗的结果。