BACKGROUND: The recovery of the spontaneous smile has become a primary focus in facial reanimation surgery and its major determinant is the selected neurotizer. We aimed to compare the spontaneity outcomes of the most preferred neurotization methods in free functional muscle transfer for long-standing facial paralysis. METHODS: The Embase, Ovid Medline, and PubMed databases were queried with 21 keywords. All clinical studies from the last 20 years reporting the postoperative spontaneity rate for specified neurotization strategies [cross-face nerve graft (CFNG), contralateral facial nerve (CLFN), motor nerve to the masseter (MNM), and dual innervation (DI)] were included. A meta-analysis of prevalence was performed using Freeman-Tukey double arcsine transformation, I2 statistic, and generic inverse variance with a random-effects model. Risk Of Bias In Non-randomized Studies of Interventions and Newcastle-Ottawa scale were used to assess bias and study quality. RESULTS: The literature search produced 2613 results and 473 unique citations for facial reanimation. Twenty-nine studies including 2046 patients were included in the systematic review. A meta-analysis of eligible data (1952 observations from 23 studies) showed statistically significant differences between the groups (CFNG: 0.94; 95% confidence interval [CI], 0.76-1.00, CLFN: 0.91; 95% CI, 0.49-1.00, MNM: 0.26; 95% CI, 0.05-0.54, DI: 0.98; 95% CI, 0.90-1.00, P < 0.001). In pairwise comparisons, statistically significant differences were found between MNM and other neurotization strategies (P < 0.001 in CFNG compared with MNM, P = 0.013 for CLFN compared with MNM, P < 0.001 for DI compared with MNM). CONCLUSIONS: DI- and CLFN-driven strategies achieved the most promising outcomes, whereas MNM showed the potential to elicit spontaneous smile at a lower extent. Our meta-analysis was limited primarily by incongruency between spontaneity assessment systems. Consensus on a standardized tool would enable more effective comparisons of the outcomes.
PURPOSE: The aim of our presentation is to introduce future eye bank product - corneal stromal lenticule from living donors, which can be used for allotransplantation. METHODS: ReLEx (refractive lenticule extraction) SMILE (small incision lenticule extraction) is a common approach in laser eye surgery. It is minimally invasive and flap-free procedure. During this procedure part of corneal stroma (lenticule) is created by femtosecond laser and consequently removed through small incision. The lenticule is basically waste material of the ReLEx SMILE procedure. In the International Eye Bank of Prague, we decided to establish new protocol for lenticule withdrawal, storage and release for transplantation. RESULTS: All donors signed an informed consent, and their serum was tested for the presence of infectious diseases. After ReLEx SMILE procedure the lenticule was stored in container with cryopreservation solution and frozen in the eye bank using the same protocol for frozen amniotic membrane. After 6 months in -80°C tissues were defrosted and examined histologically, using conventional light histology staining and electron microscopy. CONCLUSION: We believe, that lenticule from living donor is a safe and effective tissue, that can be used for many indications and in particular situations represents good alternative to whole donor cornea and amniotic membrane.
- MeSH
- lidé MeSH
- oční banky * MeSH
- rohovka MeSH
- stroma rohovky * chirurgie MeSH
- usmívání se MeSH
- žijící dárci MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: One of the critical factors in facial reanimation is selecting the donor nerve. The most favored neurotizers are the contralateral facial nerve with a cross-face nerve graft (CFNG) and motor nerve to the masseter (MNM). A relatively new dual innervation (DI) method has shown successful results. This study aimed to compare the clinical outcomes of different neurotization strategies for free gracilis muscle transfer (FGMT). METHODS: The Scopus and WoS databases were queried with 21 keywords. Three-stage article selection was performed for the systematic review. Articles presenting quantitative data for commissure excursion and facial symmetry were included in meta-analysis, using random-effects model. ROBINS-I tool and Newcastle-Ottawa scale were used to assess bias and study quality. RESULTS: One hundred forty-seven articles containing FGMT were systematically reviewed. Most studies indicated CFNG as the first choice. MNM was primarily indicated in bilateral palsy and in elderly. Clinical outcomes of DI studies were promising. 13 studies including 435 observations (179 CFNG, 182 MNM, 74 DI) were eligible for meta-analysis. The mean change in commissure excursion was 7.15 mm (95% CI: 4.57-9.72) for CFNG, 8.46 mm (95% CI: 6.86-10.06) for MNM, and 5.18 mm (95% CI: 4.01-6.34) for DI. In pairwise comparisons, a significant difference was found between MNM and DI (p = 0.0011), despite the superior outcomes described in DI studies. No statistically significant difference was found in resting and smile symmetry (p = 0.625, p = 0.780). CONCLUSIONS: CFNG is the most preferred neurotizer, and MNM is a reliable second option. Outcomes of DI studies are promising, but more comparison studies are needed to draw conclusions. Our meta-analysis was limited by incompatibility of the assessment scales. Consensus on a standardized assessment system would add value to future studies.
- MeSH
- faciální paralýza * chirurgie MeSH
- lidé MeSH
- musculus gracilis * transplantace MeSH
- senioři MeSH
- usmívání se fyziologie MeSH
- výraz obličeje MeSH
- zákroky plastické chirurgie * MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- přehledy MeSH
- systematický přehled MeSH
BACKGROUND: Assessment of motor function restoration following face transplant (FT) is difficult, as standardized, bilateral tests are lacking. This study aims to bolster support for software-based analysis through international collaboration. METHODS: FaceReader (Noldus, Wageningen, The Netherlands), a facial expression analysis software, was used to analyze posttransplant videos of eight FT patients from Boston, Massachusetts (range, 1 to 9 years after transplant), two FT patients from Helsinki, Finland (range, 3 to 4 years after transplant), and three FT patients from Antalya, Turkey (range, 6.5 to 8.5 years after transplant). Age-matched healthy controls from respective countries had no history of prior facial procedures. Videos contained patients and controls performing facial expressions evaluated by software analysis using the Facial Action Coding System. Facial movements were assigned intensity score values between 0 (absent) and 1 (fully present). Maximum values were compared with respective healthy controls to calculate percentage restoration. RESULTS: Of 13 FT patients, eight patients were full FT, five patients were partial FT, and two patients were female patients. Compared with healthy controls, the median restoration of motor function was 36.9% (interquartile range, 28.8% to 52.9%) for all patients with FT ( P = 0.151). The median restoration of smile was 37.2% (interquartile range, 31.5% to 52.7%) for all patients with FT ( P = 0.065). When facial nerve coaptation was performed at the distal branch level, average motor function restoration was 42.7% ± 3.61% compared with 27.9% ± 6.71% at the proximal trunk coaptation level ( P = 0.032). Use of interpositional nerve grafts had no influence on motor outcomes. CONCLUSIONS: Software-based analysis is suitable to assess motor function after FT. International collaboration strengthens outcome data for FT. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Many studies have demonstrated that exposure to simulated natural scenes has positive effects on emotions and reduces stress. In the present study, we investigated emotional facial expressions while viewing images of various types of natural environments. Both automated facial expression analysis by iMotions' AFFDEX 8.1 software (iMotions, Copenhagen, Denmark) and self-reported emotions were analyzed. Attractive and unattractive natural images were used, representing either open or closed natural environments. The goal was to further understand the actual features and characteristics of natural scenes that could positively affect emotional states and to evaluate face reading technology to measure such effects. It was predicted that attractive natural scenes would evoke significantly higher levels of positive emotions than unattractive scenes. The results showed generally small values of emotional facial expressions while observing the images. The facial expression of joy was significantly higher than that of other registered emotions. Contrary to predictions, there was no difference between facial emotions while viewing attractive and unattractive scenes. However, the self-reported emotions evoked by the images showed significantly larger differences between specific categories of images in accordance with the predictions. The differences between the registered emotional facial expressions and self-reported emotions suggested that the participants more likely described images in terms of common stereotypes linked with the beauty of natural environments. This result might be an important finding for further methodological considerations.
- MeSH
- emoce * fyziologie MeSH
- lidé MeSH
- výraz obličeje * MeSH
- zpráva o sobě MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Faces and their aesthetic appreciation are a core element of social interaction. Although studies have been made on facial processing when looking at faces with different perspectives, a direct comparison of faces in the left to the right perspective is missing. Portraits in classical Western art indicate a preference of the left compared to the right perspective, but the neural underpinnings of such an asymmetry still have to be clarified. Using functional magnetic resonance imaging, the current study focuses on the processing of three-quarter faces seen with different perspectives. Seventeen participants were asked to passively look at photographs of six male and six female faces with a neutral expression; the photographs were taken from the left, right, and frontal perspectives while keeping their focus on the eyes. The results showed that specific brain areas were involved in processing the three-quarter faces in either symmetric or asymmetric ways. Viewing left and right three-quarter faces resulted in two mirror-like activations in the striate cortex corresponding to the symmetric layout of the left and right perspectives. Viewing the left face resulted additionally in an enhanced activation also in the left extrastriate cortex. The right perspective of male faces elicited a lower activation compared to other perspectives in face-selective areas of the brain. Our findings suggest that the preference of the left three-quarter face emerges already in the early visual pathway presumably prior to facial identification, emotional processing, and aesthetic appreciation. Our observations may have general importance in disentangling different neural components and processing stages in the spatiotemporal characteristics of artistic expressions.
- MeSH
- emoce fyziologie MeSH
- estetika MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mapování mozku * MeSH
- mozek fyziologie MeSH
- světelná stimulace metody MeSH
- výraz obličeje MeSH
- zrakové korové centrum * fyziologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
The neuropeptide oxytocin (OXT) is suggested to exert an important role in human social behaviors by modulating the salience of social cues. To date, however, there is mixed evidence whether a single dose of OXT can improve the behavioral and neural sensitivity for emotional face processing. To overcome difficulties encountered with classic event-related potential studies assessing stimulus-saliency, we applied frequency-tagging EEG to implicitly assess the effect of a single dose of OXT (24 IU) on the neural sensitivity for positive and negative facial emotions. Neutral faces with different identities were presented at 6 Hz, periodically interleaved with an expressive face (angry, fearful, and happy, in separate sequences) every fifth image (i.e., 1.2 Hz oddball frequency). These distinctive frequency tags for neutral and expressive stimuli allowed direct and objective quantification of the neural expression-categorization responses. The study involved a double-blind, placebo-controlled, cross-over trial with 31 healthy adult men. Contrary to our expectations, we did not find an effect of OXT on facial emotion processing, neither at the neural, nor at the behavioral level. A single dose of OXT did not evoke social enhancement in general, nor did it affect social approach-avoidance tendencies. Possibly ceiling performances in facial emotion processing might have hampered further improvement.
- MeSH
- dospělí MeSH
- dvojitá slepá metoda MeSH
- elektroencefalografie MeSH
- emoce MeSH
- klinické křížové studie MeSH
- lidé MeSH
- oxytocin * farmakologie MeSH
- výraz obličeje * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
There is a large body of evidence that exposure to simulated natural scenes has positive effects on emotions and reduces stress. Some studies have used self-reported assessments, and others have used physiological measures or combined self-reports with physiological measures; however, analysis of facial emotional expression has rarely been assessed. In the present study, participant facial expressions were analyzed while viewing forest trees with foliage, forest trees without foliage, and urban images by iMotions' AFFDEX software designed for the recognition of facial emotions. It was assumed that natural images would evoke a higher magnitude of positive emotions in facial expressions and a lower magnitude of negative emotions than urban images. However, the results showed only very low magnitudes of facial emotional responses, and differences between natural and urban images were not significant. While the stimuli used in the present study represented an ordinary deciduous forest and urban streets, differences between the effects of mundane and attractive natural scenes and urban images are discussed. It is suggested that more attractive images could result in more pronounced emotional facial expressions. The findings of the present study have methodological relevance for future research. Moreover, not all urban dwellers have the possibility to spend time in nature; therefore, knowing more about the effects of some forms of simulated natural scenes surrogate nature also has some practical relevance.
- MeSH
- emoce * MeSH
- lidé MeSH
- obličej MeSH
- rozpoznávání (psychologie) MeSH
- software MeSH
- výraz obličeje * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
