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Three-Dimensional Video Analysis of Facial Movements: A New Method to Assess the Quantity and Quality of the Smile

Frey Manfred M.D.; Giovanoli, Pietro M.D.; Gerber, Hans Ph.D.; Slameczka, Michael; Stüssi, Edgar Ph.D
Plastic and Reconstructive Surgery: December 1999
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The results of neuromuscular reconstructions of the paralyzed face are difficult to assess. Very sophisticated methods are necessary to measure the motor deficits of facial paralysis or the functional recovery in the face. The aim of this development was a relatively simple system for data acquisition, which is easy to handle and which makes it relatively cheap to delegate data acquisition to centers all over the world, which will not be able to derive a data analysis on their own, but will send their data to a center with specialized equipment. A complex mirror system was developed to get three different views of the face at the same time on the video screen. At each investigation, a digital video is taken from a calibration grid and from standardized facial movements of the patient. Secondary analysis of the digital videofilm is made possible at any time later on by the support of a computer program, which calculates distances and movements three-dimensionally from the frontal image and the right and left mirror images. Pathologies of the mimic movements can be identified as well as improvements after surgical procedures by this system. The significant advantage is the possibility to watch the same movement on the video which is under study and to apply any kind of study later on. Taking the video needs only a few minutes, and fatigue of the patient's mimic system is prevented. Measurements usually at the endpoints of the movements give excellent information on the quantity of the movement or the degree of the facial palsy, whereas the video itself is very informative regarding the quality of the smile. Specific computer software was developed for standardized threedimensional analysis of the video-documented facial movements and for data presentation. There are options like two-dimensional graphs of single moving points in the face or three-dimensional graphs of the movements of all measured points at the same time during a standardized facial movement. By a comparison of the right- and leftsided alterations of specific distances between two points during the facial movements, the degree of normal symmetry or pathologic asymmetry is quantified. This system is more suitable for detailed scientific multicenter studies than any other system previously established. A very sensitive instrument for exact evaluation of mimic function is now available. (Plast. Reconstr. Surg. 104: 2032, 1999.)

From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical School, University of Vienna, and Laboratory for Biomechanics, Swiss Federal Institute of Technology (ETH). Received for publication January 21, 1999; revised May 6, 1999.

Presented at the Annual Meeting of the Austrian Society for Plastic, Aesthetic and Reconstructive Surgery, in Innsbruck-Igls, Austria, in October of 1997; the Ninth Annual Meeting of the European Association of Plastic Surgeons, in Verona, Italy, in May of 1998; the 14th Congress of the International Microsurgical Society, in Corfu, Greece, in August of 1998; and the 35th Congress of the Brazilian Society of Plastic Surgery, in Goiânia, Brazil, in October of 1998.

Manfred Frey, M.D.

Division of Plastic and Reconstructive Surgery Department of Surgery Medical School, University of Vienna Währinger Gürtel 18-20 A-1090 Vienna,

©1999American Society of Plastic Surgeons