Severity scoring approach using modified optical flow method and lesion identification for facial nerve paralysis assessment

The facial nerve controls facial movement and expression. Hence, a patient with facial nerve paralysis will experience affected social interactions, psychological distress, and low self-esteem. Upon the first presentation, it is crucial to determine the severity level of the paralysis and take out the possibility of stroke or any other serious causes by recognising the type of lesion in preventing any mistreatment of the patient. Clinically, the facial nerve is assessed subjectively by observing voluntary facial movement and assigning a score based on the deductions made by the clinician. However, the results are not uniform among different examiners evaluating the same patients. This is extremely undesirable for both medical diagnostic and treatment considerations. Acknowledging the importance of this assessment, this research was conducted to develop a facial nerve assessment that can classify both the severity level of facial nerve function and also the types of facial lesion, Upper Motor Neuron (UMN) and Lower Motor Neuron (LMN), in facial regional assessment and lesion assessment, respectively. For regional assessment, two optical flow techniques, Kanade-Lucas-Tomasi (KLT) and Horn-Schunck (HS) were used in this study to determine the local and global motion information of facial features. Nevertheless, there is a problem with the original KLT which is the inability of the Eigen features to distinguish the normal and patient subjects. Thus, the KLT method was modified by introducing polygonal measurements and the landmarks were placed on each facial region. Similar to the HS method, the multiple frames evaluation was proposed rather than a single frame evaluation of the original HS method to avoid the differences between frames becoming too small. The features of these modified methods, Modified Local Sparse (MLS) and Modified Global Dense (MGD), were combined, namely the Combined Modified Local-Global (CMLG), to discover both local (certain region) and global (entire image) flow features. This served as the input into the k-NN classifier to assess the performance of each of them in determining the severity level of paralysis. For the lesion assessment, the Gabor filter method was used to extract the wrinkle forehead features. Thereafter, the Gabor features combined with the previous features of CMLG, by focusing only on the forehead region to evaluate both the wrinkle and motion information of the facial features. This is because, in an LMN lesion, the patient will not be able to move the forehead symmetrically during the rising eyebrows movement and unable to wrinkle the forehead due to the damaged frontalis muscle. However, the patient with a UMN lesion exhibits the same criteria as a normal subject, where the forehead is spared and can be lifted symmetrically. The CMLG technique in regional assessment showed the best performance in distinguishing between patient and normal subjects with an accuracy of 92.26% compared to that of MLS and MGD, which were 88.38% and 90.32%, respectively. From the results, some assessment tools were developed in this study namely individual score, total score and paralysis score chart which were correlated with the House-Brackmann score and validated by a medical professional with 91.30% of accuracy. In lesion assessment, the combined features of Gabor and CMLG on the forehead region depicted a greater performance in distinguishing the UMN and LMN lesion of the patient with an accuracy of 89.03% compared to Gabor alone, which was 78.07%. In conclusion, the proposed facial nerve assessment approach consisting of both regional assessment and lesion assessment is capable of determining the level of facial paralysis severity and recognising the type of facial lesion, whether it is a UMN or LMN lesion

Correlation Of Objective Assessment Of Facial Paralysis With House-Brackmann Score

This article illustrated a brief review of some objective methods in assessing facial nerve function for facial nerve paralysis which were correlated with House-rackmann Grading System (HBGS).A rigorous search of online databases such as Springer,Elsevier and IEEE was conducted from June,2015 to November,2016 to discover and analyze the previous works in facial nerve assessment methods for facial paralysis.Several domains such as facial grading system and methods used to evaluate the facial nerve function were extracted for further analysis.Different keywords were used to acquire the studies based on the desire criteria.A total of 8 articles were identified and were analyzed for inclusion in this search.In conclusion,this review has presented an initial overview for further improvements in objective facial nerve assessment which has to be correlated with subjective assessment to make it more reliable and useful in clinical practice

Correlation of Objective Assessment of Facial Paralysis with House-Brackmann Score

This article illustrated a brief review of some objective methods in assessing facial nerve function for facial nerve paralysis which were correlated with House-Brackmann Grading System (HBGS). A rigorous search of online databases such as Springer, Elsevier and IEEE was conducted from June, 2015 to November, 2016 to discover and analyze the previous works in facial nerve assessment methods for facial paralysis. Several domains such as facial grading system and methods used to evaluate the facial nerve function were extracted for further analysis. Different keywords were used to acquire the studies based on the desire criteria. A total of 8 articles were identified and were analyzed for inclusion in this search. In conclusion, this review has presented an initial overview for further improvements in objective facial nerve assessment which has to be correlated with subjective assessment to make it more reliable and useful in clinical practice.

Initial assessment of facial nerve paralysis based on motion analysis using optical flow method

Patients with facial nerve paralysis suffer serious functional, cosmetic and psychological problems with impaired ability to communicate both verbally and nonverbally. Rehabilitation for facial paralysis begins with a thorough clinical evaluation in accessing the degree of paralysis. Generally, for assessment of facial nerve dysfunction on patient's face in daily clinical application, observation-based subjective grading systems by clinicians is been employed. Subjective assessments of facial nerve function are accomplished by inferring nerve function through the observation of voluntary facial movement. These methods usually yield a single value which hypothetically corresponds to the severity of facial paralysis. To date, there are no subjective assessment methods that can reliably produce quantitative information regarding facial nerve function. Previous works have proposed a wide range of methods to obtain objective data to quantify and determine the severity of facial paralysis. However, there is no standardized quantitative method for objective description of facial nerve function. Acknowledging the importance of this facial assessment, this research was conducted to develop an initial assessment methodthat can classify normal and patient subjects based on facial motion analysis using Optical Flow algorithm as well as categorizing the severity of patient into six levels according to House-Brackmann (I-TB) system. Prior to initial assessment method been developed, two experiments were conducted to find the best parameter and bestmeasurement for assessing facial paralysis. Distance and area were selected as two measurement parameters which were investigated in this research. A number of mathematical and statistical analyses were performed to determine the best measurement of these parameters. The results indicate that the distance is the best parameter and the value of initial exercise frame is the most important measurement in tracking the changes of facial movement. This thesis also presents the initial facial assessment method which contains the individual scores for each exercise involved in this research and also grading the paralysis for each patient corresponds to HB system. This research showed satisfactory results which was validated by a medical professional in Otorhinolaryngology. This initial facial assessment method may play a pivotal role in initiation of final assessment system for facial paralysis and develop better rehabilitation program for patients

Determination of Forehead Lesion in Facial Paralysis using Gabor Filter

Facial paralysis is a loss of the voluntary muscle movement due to any damages in facial nerve. The need for fast and accurate facial nerve assessment is crucial for further efficient treatment of facial nerve paralysis. Any impairment of its function can severely affect the social and psychological of a patient with this paralysis. Traditional methods are solely dependent on the subjective evaluation of clinicians and consequently lead to observant error, time-consuming and may obtain a different decision on the treatment method. A novel approach has been proposed in this study which capable to distinguish the type of lesions of facial paralysis since these lesions become the main attribute for differentiating the type of paralysis before deciding the further treatment for the patient. Gabor Filter Method with different orientation and scales have been experimented in this study. Two powerful parameters, Mean Amplitude and Local Energy, were extracted from Gabor magnitude response to determine the lesions in facial paralysis. From the results, the Local Energy measurements are better than Mean Amplitude measurements in classifying between LMN and UMN. Besides, pi/2 orientation of Local Energy feature gives the most stable and good results in classifying the data throughout the scales. In addition, Scale 1 has shown the most reasonable scale for all orientations. As a conclusion, this wrinkle analysis is capable of determining the type of lesions of facial paralysis and become a helpful tool for the clinicians in facial nerve assessment

Correlation of Objective Assessment of Facial Paralysis with House-Brackmann Score

This article illustrated a brief review of some objective methods in assessing facial nerve function for facial nerve paralysis which were correlated with House-Brackmann Grading System (HBGS). A rigorous search of online databases such as Springer, Elsevier and IEEE was conducted from June, 2015 to November, 2016 to discover and analyze the previous works in facial nerve assessment methods for facial paralysis. Several domains such as facial grading system and methods used to evaluate the facial nerve function were extracted for further analysis. Different keywords were used to acquire the studies based on the desire criteria. A total of 8 articles were identified and were analyzed for inclusion in this search. In conclusion, this review has presented an initial overview for further improvements in objective facial nerve assessment which has to be correlated with subjective assessment to make it more reliable and useful in clinical practice

Forehead lesion score for facial nerve paralysis evaluation

Facial nerve paralysis is mostly occurring from a temporary or permanent injury to any of facial nerves which drive the failure of facial nerve function. As a consequence, the facial muscles will not receive the necessary signals from the facial nerves in order to function properly and caused the weakness of facial muscles. This facial paralysis affects both verbal and non-verbal communication which has important function and essential element to the development of an individual. The subjective facial nerve assessment involves the assessment of forehead movement which designates whether the lesion is at the level of the upper motor neuron (has movement on both sides) or the lower motor neuron (no movement on paralysed side). An objective assessment of these lesions will give a great impact in managing the symptoms and limiting the sequelae of the paralysis compared to the subjective assessment. A forehead lesion score was developed in this study to differentiate the two types of lesion of facial paralysis, Upper Motor Neuron (UMN) and Lower Motor Neuron (UMN) lesion. Two potential features were extracted from Gabor filter, Mean Amplitude and Local Energy. The best scale and orientation of these features were chosen after the selection of best threshold value. The accuracy percentage by using the Local Energy feature in classifying the UMN is 100% and LMN lesion is 73%. From the results, a forehead lesion score is developed. As a conclusion, this lesion score has the outstanding ability in specifying the facial lesion types and may become a great aid to clinicians for an efficient facial nerve evaluation

Introduction of Static and Dynamic Features to Facial Nerve Paralysis Evaluation

This paper presents a novel approach of facial nerve paralysis evaluation system where it includes both static and dynamic features to evaluate the severity level of paralysis and classify the type of paralysis whether it is Upper Motor Neuron (UMN) lesion or Lower Motor Neuron (LMN) lesion. Two assessment proposed in the system, regional assessment and lesion assessment, which used static and dynamic features respectively. Individual score, total score and paralysis score are introduced and experiments reveal that the proposed approach demonstrates till 100% accuracy in classifying the subjects into normal and patient, the level of severity, and also the type of lesion by using the k-NN classifier. The results proved that with more experiments and by increasing the number of the data, the system will become a great aid to clinicians in evaluation of facial nerve paralysis and rehabilitation programs to patients

Introduction of Forehead Lesion Assessment with House-Brackmann Score for Facial Nerve Paralysis Evaluation

This paper present a novel approach of forehead lesion assessment using Gabor filter method to identify the type of facial nerve paralysis and proposed a forehead-HB score table to assist the clinicians in assessing the facial nerve function quantitatively, quicker and in a convenient way. A 100% of accuracy has been obtained in identifying the two type of facial lesion, Upper Motor Neuron (UMN) and Lower Motor Neuron (LMN) lesion. Increasing more data may enhance the performance of the accurac

Regional assessment of facial nerve paralysis using optical flow method

This paper presents an ultra-wideband pyramidal horn antenna for non-destructive fruit quality monitoring system. The proposed design simulation operates in the frequency range of 3.1–10.6 GHz. The antenna is supported by the rectangular waveguide feeder. The design is chosen based on the ability of the antenna to transmit and receive signal with wide bandwidth, high directivity and gain, and low Voltage Standing Wave Ratio. The antenna is designed and simulated by using Computer Simulation Technology Microwave Studio. The simulation result also validated by the experimental result. The simulation result shows that the proposed UWB pyramidal horn antenna exhibits small return loss with low VSWR as well as good radiation pattern in the frequency range of 3.1–10.6 GHz