Bell's palsy

Bellova se pareza definira kao iznenadna, izolirana i jednostrana periferna pareza lica uzrokovana oštećenjem ličnog živca nepoznatog uzroka, zbog čega se naziva i idiopatskom. Ime je dobila prema škotskom liječniku sir Charlesu Bellu koji je u prvoj polovici 19. stoljeća objavio niz radova o perifernoj paralizi ličnog živca. Najčešća je to periferna pareza ličnog živca čija se incidencija u općoj populaciji kreće između 13 i 53,3 na 100.000 stanovnika u godini dana. Može se pojaviti u bilo kojoj dobnoj skupini, a najčešće zahvaća onu od 15. do 45. godine života. Točan joj se uzrok ne zna, no u literaturi su najzastupljenije dvije etiološke hipoteze – virološka i autoimuna. Brojne su histološke promjene ličnog živca (unutar njegova koštanog kanala) prisutne kod pacijenata oboljelih od Bellove pareze, poput upalnog infiltrata, edema i demijelinizacije. Bolest se očituje karakterističnom slabosti mimičnih mišića, no zbog brojnih funkcija ličnog živca mogu biti prisutni i drugi pridruženi simptomi (retroaurikularna bol, smetnje suzenja i okusa, hiperakuzija), čija prisutnost ovisi o tome na kojoj je razini živčanog toka došlo do oštećenja. Temelj dijagnostike Bellove pareze jesu iscrpna anamneza i detaljan klinički pregled čime se pokušava isključiti pareza facijalisa poznatog uzroka. Također, potrebno je odrediti stupanj funkcije ličnog živca koristeći se nekom od dostupnih ljestvica za procjenu, primjerice House-Brackmannovom (HB) ljestvicom ili Sunnybrook (SB) sustavom procjene. Liječenje ove bolesti jest multidimenzionalno, a temelj mu čini medikamentozna terapija kortikosteroidima. Uz njih, neizostavan dio terapije su i potporne mjere, poput zaštite oka, kao i vježbe mimične muskulature radi očuvanja tonusa mišića.Bell's palsy is defined as a sudden, isolated and unilateral peripheral facial palsy. It is caused by facial nerve damage of unknown origin and therefore called idiopathic. It was named after the Scottish physician, Sir Charles Bell, who had published several papers on the topic in the first half of the 19th century. It is the most common of all peripheral facial palsies, with an annual incidence in the general population of 13 to 53.3 cases per 100,000 people. It is most common in people aged 15–45, but it may affect any age. Even though its exact cause is unknown, two main etiological hypotheses are represented in medical literature: viral and autoimmune. There are numerous histological changes to the intraosseous segment of facial nerve present in patients with Bell’s palsy, such as inflammatory cell infiltration, edema, and demyelination. The disease presents with typical weakness of facial muscles. However, due to numerous facial nerve functions, several other symptoms may be present, such as retroauricular pain, altered taste, decreased tearing, or hyperacusis. Their presentation depends on the localization of the facial nerve lesion. An extensive clinical examination and thorough patient history are the two key elements in the diagnostics of Bell's palsy, as they will eliminate the identifiable causes of facial palsy. Moreover, the facial nerve function has to be evaluated using one of the common scoring systems, e.g., the House-Brackmann (HB) facial nerve grading system or the Sunnybrook (SB) facial grading system. The treatment of Bell's palsy is multimodal but always includes the administration of corticosteroids. Besides medication, supportive measures, such as eye protection and mime therapy (muscle tone preservation exercises) are also vital parts of the aforementioned multimodal treatment

Bell's palsy

Bellova se pareza definira kao iznenadna, izolirana i jednostrana periferna pareza lica uzrokovana oštećenjem ličnog živca nepoznatog uzroka, zbog čega se naziva i idiopatskom. Ime je dobila prema škotskom liječniku sir Charlesu Bellu koji je u prvoj polovici 19. stoljeća objavio niz radova o perifernoj paralizi ličnog živca. Najčešća je to periferna pareza ličnog živca čija se incidencija u općoj populaciji kreće između 13 i 53,3 na 100.000 stanovnika u godini dana. Može se pojaviti u bilo kojoj dobnoj skupini, a najčešće zahvaća onu od 15. do 45. godine života. Točan joj se uzrok ne zna, no u literaturi su najzastupljenije dvije etiološke hipoteze – virološka i autoimuna. Brojne su histološke promjene ličnog živca (unutar njegova koštanog kanala) prisutne kod pacijenata oboljelih od Bellove pareze, poput upalnog infiltrata, edema i demijelinizacije. Bolest se očituje karakterističnom slabosti mimičnih mišića, no zbog brojnih funkcija ličnog živca mogu biti prisutni i drugi pridruženi simptomi (retroaurikularna bol, smetnje suzenja i okusa, hiperakuzija), čija prisutnost ovisi o tome na kojoj je razini živčanog toka došlo do oštećenja. Temelj dijagnostike Bellove pareze jesu iscrpna anamneza i detaljan klinički pregled čime se pokušava isključiti pareza facijalisa poznatog uzroka. Također, potrebno je odrediti stupanj funkcije ličnog živca koristeći se nekom od dostupnih ljestvica za procjenu, primjerice House-Brackmannovom (HB) ljestvicom ili Sunnybrook (SB) sustavom procjene. Liječenje ove bolesti jest multidimenzionalno, a temelj mu čini medikamentozna terapija kortikosteroidima. Uz njih, neizostavan dio terapije su i potporne mjere, poput zaštite oka, kao i vježbe mimične muskulature radi očuvanja tonusa mišića.Bell's palsy is defined as a sudden, isolated and unilateral peripheral facial palsy. It is caused by facial nerve damage of unknown origin and therefore called idiopathic. It was named after the Scottish physician, Sir Charles Bell, who had published several papers on the topic in the first half of the 19th century. It is the most common of all peripheral facial palsies, with an annual incidence in the general population of 13 to 53.3 cases per 100,000 people. It is most common in people aged 15–45, but it may affect any age. Even though its exact cause is unknown, two main etiological hypotheses are represented in medical literature: viral and autoimmune. There are numerous histological changes to the intraosseous segment of facial nerve present in patients with Bell’s palsy, such as inflammatory cell infiltration, edema, and demyelination. The disease presents with typical weakness of facial muscles. However, due to numerous facial nerve functions, several other symptoms may be present, such as retroauricular pain, altered taste, decreased tearing, or hyperacusis. Their presentation depends on the localization of the facial nerve lesion. An extensive clinical examination and thorough patient history are the two key elements in the diagnostics of Bell's palsy, as they will eliminate the identifiable causes of facial palsy. Moreover, the facial nerve function has to be evaluated using one of the common scoring systems, e.g., the House-Brackmann (HB) facial nerve grading system or the Sunnybrook (SB) facial grading system. The treatment of Bell's palsy is multimodal but always includes the administration of corticosteroids. Besides medication, supportive measures, such as eye protection and mime therapy (muscle tone preservation exercises) are also vital parts of the aforementioned multimodal treatment

Facial Paralysis Grading Based on Dynamic and Static Features

Peripheral facial nerve palsy, also known as facial paralysis (FP), is a common clinical disease, which requires subjective judgment and scoring based on the FP scale. There exists some automatic facial paralysis grading methods, but the current methods mostly only consider either static or dynamic features, resulting in a low accuracy rate of FP grading. This thesis proposes an automatic facial paralysis assessment method including both static and dynamic characteristics. The first step of the method performs preprocessing on the collected facial expression videos of the subjects, including rough video interception, video stabilization, keyframe extraction, image geometric normalization and gray-scale normalization. Next, the method selects as keyframes no facial expression state and maximum facial expression state in the image data to build the the research data set. Data preprocessing reduces errors, noise, redundancy and even errors in the original data. The basis for extracting static and dynamic features of an image is to use Ensemble of Regression Trees algorithm to determine 68 facial landmarks. Based on landmark points, image regions of image are formed. According to the Horn-Schunck optical flow method, the optical flow information of parts of the face are extracted, and the dynamic characteristics of the optical flow difference between the left and right parts are calculated. Finally, the results of dynamic and static feature classification are weighted and analyzed to obtain FP ratings of subjects. A 32-dimensional static feature is fed into the support vector machine for classification. A 60-dimensional feature vector of dynamical aspects is fed into a long and short-term memory network for classification. Videos of 30 subjects are used to extract 1419 keyframes to test the algorithm. The accuracy, precision, recall and f1 of the best classifier reach 93.33%, 94.29%, 91.33% and 91.87%, respectively.Perifeerinen kasvojen hermohalvaus, joka tunnetaan myös nimellä kasvojen halvaus (FP), on yleinen kliininen sairaus, joka vaatii subjektiivista arviointia ja FP -asteikon pisteytystä. Joitakin automaattisia kasvohalvauksen luokittelumenetelmiä on olemassa, mutta yleensä ottaen ne punnitsevat vain joko staattisia tai dynaamisia piirteitä. Tässä tutkielmassa ehdotetaan automaattista kasvojen halvaantumisen arviointimenetelmää, joka kattaa sekä staattiset että dynaamiset ominaisuudet. Menetelmän ensimmäinen vaihe suorittaa ensin esikäsittelyn kohteiden kerätyille kasvojen ilmevideoille, mukaan lukien karkea videon sieppaus, videon vakautus, avainruudun poiminta, kuvan geometrinen normalisointi ja harmaasävyjen normalisointi. Seuraavaksi menetelmä valitsee avainruuduiksi ilmeettömän tilan ja kasvojen ilmeiden maksimitilan kuvadatasta kerryttäen tutkimuksen data-aineiston. Tietojen esikäsittely vähentää virheitä, kohinaa, redundanssia ja jopa virheitä alkuperäisestä datasta. Kuvan staattisten ja dynaamisten piirteiden poimimisen perusta on käyttää Ensemble of Regression Trees -algoritmia 68 kasvojen merkkipisteiden määrittämiseen. Merkkipisteiden perusteella määritellään kuvan kiinnostavat alueet. Horn-Schunckin optisen virtausmenetelmän mukaisesti poimitaan optisen virtauksen tiedot joistakin kasvojen osista, ja dynaaminen luonnehdinta lasketaan vasempien ja oikeiden osien välille. Lopuksi dynaamisen ja staattisen piirteiden luokittelun tulokset painotetaan ja analysoidaan kattavasti koehenkilöiden FP-luokitusten saamiseksi. 32- ulotteinen staattisten piirteiden vektori syötetään tukivektorikoneeseen luokittelua varten. 60-ulotteinen dynaamisten piirteiden ominaisuusvektori syötetään pitkän ja lyhyen aikavälin muistiverkkoon luokittelua varten. Parhaan luokittelijan tarkkuus, täsmällisyys, palautustaso ja f1 saavuttavat arvot 93,33%, 94,29%, 91,33% ja 91,87%

Profiling bell's palsy based on House-Brackmann score

In this study, we propose to examine facial nerve palsy using Support Vector Machines (SVMs) and Emergent Self-Organizing Map (ESOM). This research seeks to analyze facial palsy domain using facial features and grade the degree of nerve damage according to House-Brackmann score. Traditional evaluation methods involve a medical doctor taking a thorough history of a patient and determines the onset of the paralysis, the rate of progression and etc. The most important step is to assess the degree of voluntary movement present and document the grade of facial paralysis using House-Brackmann score. The significance of this work is that we attempt to apprehend this grading using semi-supervised learning with the aim of automating this grading process. The value of this research stems from the fact that there is a lack of literature seen in this area. The use of automated grading system greatly reduces assessment time and increases consistency because references of all palsy images are stored to provide references and comparison. The proposed automated diagnostics methods are computationally efficient making them ideal for remote assessment of facial palsy, profiling of a large number of facial images captured using mobile phones and digital cameras

PRELIMINARY FINDINGS OF A POTENZIATED PIEZOSURGERGICAL DEVICE AT THE RABBIT SKULL

The number of available ultrasonic osteotomes has remarkably increased. In vitro and in vivo studies have revealed differences between conventional osteotomes, such as rotating or sawing devices, and ultrasound-supported osteotomes (Piezosurgery®) regarding the micromorphology and roughness values of osteotomized bone surfaces. Objective: the present study compares the micro-morphologies and roughness values of osteotomized bone surfaces after the application of rotating and sawing devices, Piezosurgery Medical® and Piezosurgery Medical New Generation Powerful Handpiece. Methods: Fresh, standard-sized bony samples were taken from a rabbit skull using the following osteotomes: rotating and sawing devices, Piezosurgery Medical® and a Piezosurgery Medical New Generation Powerful Handpiece. The required duration of time for each osteotomy was recorded. Micromorphologies and roughness values to characterize the bone surfaces following the different osteotomy methods were described. The prepared surfaces were examined via light microscopy, environmental surface electron microscopy (ESEM), transmission electron microscopy (TEM), confocal laser scanning microscopy (CLSM) and atomic force microscopy. The selective cutting of mineralized tissues while preserving adjacent soft tissue (dura mater and nervous tissue) was studied. Bone necrosis of the osteotomy sites and the vitality of the osteocytes near the sectional plane were investigated, as well as the proportion of apoptosis or cell degeneration. Results and Conclusions: The potential positive effects on bone healing and reossification associated with different devices were evaluated and the comparative analysis among the different devices used was performed, in order to determine the best osteotomes to be employed during cranio-facial surgery