• Archives of Craniofacial Surgery
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• v.12 no.2
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• pp.86-92
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• 2011

Purpose: The purpose of this study was to investigate the possibility that a dynamic facial composite flap with sensory and motor nerves could be made available from donor facial composite tissue. Methods: The faces of 3 human cadavers were dissected. The authors studied the donor faces to assess which facial composite model would be most practicable. A "panorama facial flap" was excised from each facial skeleton with circumferential incision of the oral mucosa, lower conjunctiva and endonasal mucosa. In addition, the authors measured the available length of the arterial and venous pedicles, and the sensory nerves. In the recipient, the authors evaluated the time required to anastomose the vessels and nerve coaptations, anchor stitches for donor flaps, and skin stitches for closure. Results: In the panorama facial flap, the available anastomosing vessels were the facial artery and vein. The sensory nerves that required anastomoses were the infraorbital nerve and inferior alveolar nerve. The motor nerve requiring anstomoses was the facial nerve. The vascular pedicle of the panorama facial flap is the facial artery and vein. The longest length was 78 mm and 48 mm respectively. Sensation of the donor facial composite is supplied by the infraorbital nerve and inferior alveolar nerve. Motion of the facial composite is supplied by the facial nerve. Some branches of the facial nerve can be anastomosed, if necessary. Conclusion: The most practical facial composite flap would be a mid and lower face flap, and we proposed a panorama facial flap that is designed to incorporate the mid and lower facial skin with and the unique tissue of the lip. The panorama facial composite flap could be considered as one of the practicable basic models for facial allotransplantation.

• Journal of Korean Academy of Nursing
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• v.46 no.4
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• pp.542-551
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• 2016

Purpose: The purpose of this study was to examine the effects of a facial muscle exercise program including facial massage on the facial muscle function, subjective symptoms related to paralysis and depression in patients with facial palsy. Methods: This study was a quasi-experimental research with a non-equivalent control group non-synchronized design. Participants were 70 patients with facial palsy (experimental group 35, control group 35). For the experimental group, the facial muscular exercise program including facial massage was performed 20 minutes a day, 3 times a week for two weeks. Data were analyzed using descriptive statistics, ${\chi}^2$-test, Fisher's exact test and independent sample t-test with the SPSS 18.0 program. Results: Facial muscular function of the experimental group improved significantly compared to the control group. There was no significant difference in symptoms related to paralysis between the experimental group and control group. The level of depression in the experimental group was significantly lower than the control group. Conclusion: Results suggest that a facial muscle exercise program including facial massage is an effective nursing intervention to improve facial muscle function and decrease depression in patients with facial palsy.

• The Journal of Korean Physical Therapy
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• v.33 no.6
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• pp.297-303
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• 2021

Purpose: The mass of facial muscles can be increased through exercise, as is also the case for muscles in the extremities. This systematic review was conducted to investigate the effect of facial exercises on facial muscle strengthening and facial rejuvenation, focusing on recent studies. Methods: A literature search was performed using the PubMed, ScienceDirect, and Web of Science databases. The quality of the trials was evaluated according to the PEDro scale. In total, 11 studies were included in this review: four studies on facial exercise for facial rejuvenation and seven studies on strengthening the muscles of the face. Results: Facial exercises for facial rejuvenation increased the mechanical properties and elasticity of the skin of the face and neck, the thickness and cross-sectional area of the facial muscles, and the fullness of the upper and lower cheeks. Conclusion: A study aimed at strengthening facial muscles showed improvements in labial closure strength and tongue elevation strength. Despite the positive results for facial rejuvenation and muscle strengthening, the level of evidence was low. Therefore, in future research, it will be necessary to investigate the effects of facial exercise in a thoroughly controlled experiment with a sufficient sample size to increase the level of evidence.

• Journal of Information Technology Applications and Management
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• v.10 no.4
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• pp.135-147
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• 2003

With the development of multimedia and optical technologies, application systems with facial features hare been increased the interests of researchers, recently. The previous research efforts in face processing mainly use the frontal images in order to recognize human face visually and to extract the facial expression. However, applications, such as image database systems which support queries based on the facial direction and image arrangement systems which place facial images automatically on digital albums, deal with the directional characteristics of a face. In this paper, we propose a method to detect facial directions by using facial features. In the proposed method, the facial trapezoid is defined by detecting points for eyes and a lower lip. Then, the facial direction formula, which calculates the right and left facial direction, is defined by the statistical data about the ratio of the right and left area in facial trapezoids. The proposed method can give an accurate estimate of horizontal rotation of a face within an error tolerance of $\pm1.31$ degree and takes an average execution time of 3.16 sec.

• Journal of Korean Dental Science
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• v.15 no.1
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• pp.19-30
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• 2022

Purpose: The purpose of the study was to assess the validity of three-dimensional (3D) facial scan taken with facial scanner and digital photo wrapping on the cone-beam computed tomography (CBCT). Materials and Methods: Twenty-five patients had their CBCT scan, two-dimensional (2D) standardized frontal photographs and 3D facial scan obtained on the same day. The facial scans were taken with a facial scanner in an upright position. The 2D standardized frontal photographs were taken at a fixed distance from patients using a camera fixed to a cephalometric apparatus. The 2D integrated facial models were created using digital photo wrapping of frontal photographs on the corresponding CBCT images. The 3D integrated facial models were created using the integration process of 3D facial scans on the CBCT images. On the integrated facial models, sixteen soft tissue landmarks were identified, and the vertical, horizontal, oblique and angular distances between soft tissue landmarks were compared among the 2D facial models and 3D facial models, and CBCT images. Result: The results showed no significant differences of linear and angular measurements among CBCT images, 2D and 3D facial models except for Se-Sn vertical linear measurement which showed significant difference for the 3D facial models. The Bland-Altman plots showed that all measurements were within the limit of agreement. For 3D facial model, all Bland-Altman plots showed that systematic bias was less than 2.0 mm and 2.0° except for Se-Sn linear vertical measurement. For 2D facial model, the Bland-Altman plots of 6 out of 11 of the angular measurements showed systematic bias of more than 2.0°. Conclusion: The facial scan taken with facial scanner showed a clinically acceptable performance. The digital 2D photo wrapping has limitations in clinical use compared to 3D facial scans.

• 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.

• Journal of Korean Academy of Nursing
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• v.31 no.6
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• pp.1044-1054
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• 2001

The purpose of this study was to develop on east-west nursing intervention program. This study was conducted to identify the effectiveness of using facial meridian points for massage nursing intervention on the recovery of facial paralysis for 46 patients (22 for experimental group). All had suffered from strokes, and were also admitted to the division of oriental medicine in K University Hospital. Method: Data was collected from February 1st to December 31st of 2000. This study used a quasi experimental, non-equivalent control group pre-test and post-test design. The recovery of facial paralysis was measured by the difference between left and right facial length, observation and self report on a seven point scale, and facial discomfort by a facial scale after 6-7 facial massages in a two week period. Data was analyzed using the SPSS package program with x2 and t test. Result: The result of this study are as follows; The experimental group who received the facial meridian massage showed higher scores in recovery of facial paralysis (t=2.72, p=.009), and a smaller difference between left and right facial strength than those in control group (t=2.26, p= .29). The discomfort of the facial area in the experimental and control group showed no significant differences. Conclusion: These findings indicate that a facial meridian points massage could be an effective nursing intervention to the recovery of facial paralysis. This study contributes in developing an east-west nursing intervention with the oriental meridian theory and western massage therapy.

• Archives of Plastic Surgery
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• v.41 no.6
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• pp.716-721
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• 2014

Background The aim of this study was to review the recipient vessels used in our cases of facial reanimation with free functional muscle transfer and to identify patient variables that may predict when the facial vessels are absent. From this we present a protocol for vessel selection in cases when the facial artery and/or vein are absent. Methods Patients were identified from November 2006 to October 2013. Data was collected on patient demographics, facial palsy aetiology, history of previous facial surgery/trauma and flap/recipient vessels used. A standard operative approach was adopted and performed by a single surgeon. Results Eighty-seven eligible patients were identified for inclusion amongst which 98 hemifaces were operated upon. The facial artery and vein were the most commonly used recipient vessels (90% and 83% of patients, respectively). Commonly used alternative vessels were the transverse facial vein and superficial temporal artery. Those with congenital facial palsy were significantly more likely to lack a suitable facial vein (P=0.03) and those with a history of previous facial surgery or trauma were significantly more likely to have an absent facial artery and vein (P<0.05). Conclusions Our algorithm can help to guide vessel selection cases of facial reanimation with free functional muscle transfer. Amongst patients with congenital facial palsy or in those with a previous history of facial surgery or trauma, the facial vessels are more likely to be absent and so the surgeon should then look towards the transverse facial vein and superficial temporal artery as alternative recipient structures.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.719-724
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• 2011

Purpose: Previous studies of the facial artery have shown significant anatomical variability in this region. The vascular anatomy of the region is considered unreliable in predicting the ideal pedicle. Preoperative imaging has been suggested as a means of improving preoperative awareness, with Doppler ultrasound as useful tools. Multi-detector row angiographic computed tomography (angio CT) is a significant improvement, providing noninvasive operator-independent details of the vascular anatomy. This tool was used to perform an $in$ $vivo$ anatomical study of the facial artery, demonstrating the usefulness of facial angio CT in planning the facial reconstruction. Methods: Eleven consecutive patients underwent facial angio CT of the facial vasculature with the anatomical details of the facial artery assessed. Results: Facial angio CT could demonstrate the size and course of the facial vasculature, particularly the facial artery. Conclusion: The vascular anatomy of the facial artery is highly variable, and thus there is a role for preoperative imaging. Facial angio CT can demonstrate cases where there is an aberrant or non-preferred anatomy, or select the method of a facial reconstruction.

• Journal of Oriental Medical Thermology
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• v.6 no.1
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• pp.32-38
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• 2008

Objective: To investigate the changes of facial temperature by Miso Facial Rejuvenation Acupuncture treatment. Methods: One middle-aged women who has no other disease was recruited. The Miso Facial Rejuvenation Acupuncture was performed on only right face. We measured the facial temperature using the Digital Infrared Thermal Imaging (DOREX Inc. Spectrum 9000 MB, USA, D.I.T.I.) before, immediate after and 10 minutes after treatment. And we used the Wilcoxon signed rank test (P<0.05) to compare the difference of facial temperature at each time. Results: Right facial temperature (the area treated by acpuncuture) increased immediately from $30.02{\pm}1.87^{\circ}C$ to $32.24{\pm}1.03^{\circ}C$, the change of temperature is statistically significant. At 10 minutes after treatment, right facial temperature decreased little, but there was no statistical significance. Left facial temperature increased little, but there was no statistical significance. The difference between right and left face increased after Miso facial rejuvenation acupuncture treatment. Conclusion: Miso facial rejuvenation acupuncture could make the facial temperature increase.