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（应用程序提供）：面部麻痹患者具有明显的面部残疾，包括面部毁容和软组织运动的损害，尤其是在面部表达行为中。这些负面的后遗症不仅会影响面部美学和功能，还影响患者的社会和情感生活质量（QOL）。治疗范围从非手术干预措施和面部复活手术到新的植入式面部起搏装置，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是基于由2D照片和受试者脸部分级的孤立测量值进行的，这两者在范围和尺寸上都受到限制。我们的研究证明了面部软组织功能评估（NIH）的新型，具有里程碑意义的3D动态和静态定量（客观）措施的实用性 DE 013814，DE 016964和DE 013814-08S1）。这些测量已得到验证，用于用于唇裂/pa/p）患者人群中。测量是客观和定量的。它们提供了面部软组织障碍的更精确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动态和静态测量在面部瘫痪患者中的损害和幻觉测量以及随时间变化的适用性。我们还将探讨基于非地标的动态和静态测量的实用性。全球研究问题是，与当前评估方法相比，使用测量结果将对面部瘫痪的严重程度和随时间变化（恢复）的变化提供更全面的分析。该研究的具体目的是：特定目的1。用于定量评估急性，单侧，脆弱的面部瘫痪的患者面部软组织残疾（面部障碍和毁容）的范围，并跟踪随时间变化（3个月恢复期）的变化，并比较年龄段和性别的患者的面部残疾。具体目的2。在患有急性单侧，松弛的面部瘫痪的患者中，可以比较当前的定性临床评估方法，以进行面部障碍和毁容（房屋束缚的面部神经渐变系统和SunnyBrook的面部渐变系统）与客观定量评估的质量分析，以评估质量分析，以评估质量分析，以评估质量分析。特定目的3。（a）评估急性，单侧，松弛的面部瘫痪患者对面部外观和QOL的看法，并将这些感知与对照组受试者的看法进行比较，以及（b）随着时间的推移，将患者的看法与面部残疾的定量度量相关联。最终，这项研究是独一无二的 面部瘫痪患者的康复是因为重点是产生新颖，客观，3D措施来表征状况和临时变化，以及生成未来假设以优化干预措施并评估不同治疗结果的结果。