眼部运动时面部相关联点运动的三维定量分析

目的探索眼部运动时,面部相关联部位运动的特点,为评价周围性面瘫时面部联动提供参考。方法健康志愿者22人(45-60岁),利用自行设计的"基于运动捕捉的面部运动三维动态定量分析系统"记录并分析"用力抬眉""用力闭眼"两个表情动作中,面部相关标记点的运动,使用移动距离(Smax)及运动速率(Vmax)两个参数描述其运动。结果 1."用力抬眉"动作,眉弓点左9.75mm,24.11mm/s,右10.14mm,25.87mm/s;除眼周标记点外,余标记点均有运动,移动距离为3.65mm至4.46mm,鼻唇沟点的运动速率明显大于其他标记点,左60.60mm/s,右62.70mm/s。口角点、鼻唇沟点运动距离、速率与眉弓点对应参数间线性相关关系强。2."用力闭眼"动作,上眼睑点移动距离和速率最大,左10.56mm,87.68mm/s,右10.54mm,81.83mm/s。除眼周标记点外,余标记点均有运动,移动距离1.58mm至1.92mm,运动速率分布于11.40-14.76mm/s。口角点、鼻唇沟点运动距离、速率与上眼睑点相关参数线性相关关系差。结论健康人进行眼部主动运动时,会引起面部其他标记点发生运动,其获得最大距离、最大速率的时间一致,用力闭眼动作中运动幅度最大的点在口角点,用力抬眉动作速率最大点在鼻唇沟点,运动距离最大的点在下唇中点。     

单侧面神经切除后面部运动特征定量分析

目的应用面部三维动态定量分析系统(3-Dimensional Analysis System for Facial Motion,3D-ASFM)对面神经部分切除术后的患者进行测量,探讨修复与未修复患者面部静态和动态指标的变化。方法 14例面神经部分切除患者,分为神经修复组(9例)和未修复组(5例)。对所有患者进行半年以上跟踪随访,中位随访期13个月。所有患者术前及术后均进行面部运动主观评估(House-Brackmann分级和Sunnybrook评分)和面部三维动态测量。比较三种评估结果相关性。比较修复组与未修复组患者术前、术后各评估结果,对修复组患者各面部区域进行分析。结果 3D-ASFM分析结果分别与House-Brackmann分级(H-BGS)、Sunnybrook评分(SFGS)进行秩相关分析,相关系数分别为-0.707(P<0.05)和0.798(P<0.05)。面瘫越严重,3D-ASFM与主观评价系统的相关性越差。术后H-BGS、SFGS总分均存在统计学差异(P<0.05),修复组好于未修复组,3D-ASFM总分在两组间无统计学差异(P>0.05),但鼻旁运动好于未修复者。修复组患者术前、术后H-BGS、SFGS、3D-ASFM总分均无统计学差异(P>0.05)。所有患者健侧动态指标中,上面部运动较术前减小,下面部运动较术前增加。结论面部三维动态定量分析结果与传统主观评价系统有较好的相关性。神经修复对面中部运动影响最大。面神经切除手术不仅造成同侧面部运动改变,也会影响对侧面部运动。     

面部运动录像分析法

目的　研究一种新的、客观评价面神经运动功能的方法即面部运动录像分析法(videomimicography ,VMG)。方法　受试者面部作 11个标记点 ,进行 5种面部运动 (皱额、闭眼、皱鼻、吹哨和微笑 ) ,使用数字式录像机进行录像。每个动作要求用最大的收缩强度重复 3次。选取 3个静息状态画面和 15个最大运动画面 (每个运动选 3个 ) ,在软件控制下输入计算机 ,进行图形测量。分析每一个运动时每侧面部 10个距离指标和 5个面积指标的变化。首先分析 10例健康人 ,找出每一运动的最佳评价指标。从这些最佳指标加权计算出一个综合指数。分析 4 8例面瘫患者 ,研究该综合指数与面瘫的House Brackmann分级的相关性。结果　正常组结果显示 :面积指标优于距离指标。每一运动有相应的最佳评价指标。面瘫患者组 :根据正常组得出的最佳指标加权计算得出VMG值 ,根据瘫痪侧的VMG值占健侧VMG值的百分率计算出VMG指数。VMG指数与面瘫的House Brackmann级数呈很好的线性相关 (r=- 0 92 8) ,并具有统计学意义 (P <0 0 0 1)。该实验在健康对照组和面瘫患者组均具有很好的重复性。结论　本方法具有客观、定量、重复性好和简便、易行的优点 ,对临床评价面神经运动功能具有实际意义。     

大鼠眼睑运动加速度及角加速度的三维动态定量测量

目的探索面瘫大鼠眼睑运动三维动态测量,尤其是加速度及角加速度指标,为定量评价面瘫大鼠模型的眼睑运动提供方法。方法建立面瘫大鼠模型54只,使用自主设计的三维动态面肌运动测量系统采集大鼠面部与眼睑运动相关标记点的运动,计算其运动加速度及角加速度指标,统计分析其规律。结果实验纳入的加速度及角加速度,实验组的面瘫侧与健侧,或实验组与对照组间有明显统计学差异;1.单侧测量指标中:(1)上睑中点相对下睑中点运动加速度最大值,对照组为左侧1949mm/s^2,右侧为1895mm/s^2,无明显统计学差异(P=0.98>0.05),右侧/左侧比值为0.99;实验组左侧为1694mm/s^2,右侧为452mm/s^2,有明显统计学差异(P=0.00<0.05),右侧/左侧比值为0.25,与对照组比值的分布有明显统计学差异(P=0.00<0.05)。小于上睑中点相对于内眦点运动加速度最大值及下睑中点相对于内眦点运动加速度最大值。(2)内眦角的角加速度最大值,对照组为左侧12416°/s^2,右侧为12813°/s^2,无明显统计学差异(P=0.81>0.05),右侧/左侧比值为1.00;实验组左侧为12532°/s^2,右侧为894°mm/s^2,有明显统计学差异(P=0.00<0.05),右侧/左侧比值为0.07,与对照组比值有明显统计学差异(P=0.00<0.05)。2.双侧测量指标中:(1)右侧上睑中点相对于左侧上睑中点运动加速度的最大值,对照组为2472mm/s^2,实验组为2461mm/s^2,无明显统计学差异(P=0.53>0.05);(2)以鼻尖为顶点,左侧上睑中点及右侧上睑中点为边的角,其角加速度最大值,对照组为5007°/s^2,实验组为3328°/s^2,有明显统计学差异(P=0.00<0.05。结论该系统可适用于测量大鼠等小型实验动物的眼睑运动的加速度和角加速度,实现小型动物的三维、定量、动态、连续测量。     

感觉统合训练结合口部运动治疗儿童构音障碍的疗效探析

目的 观察对儿童构音障碍实施感觉统合训练+口部运动治疗的效果,进而为此类患儿治疗提供指导。方法 选择本院耳鼻喉科诊疗的74例儿童构音障碍患儿为研究主体,按照奇偶法实施分组,对照组中37例患儿仅实施口部运动治疗,研究组中37例患儿接受感觉统合训练+口部运动,持续干预3个月后对比各组治疗效果、口部运动、相关指标（构音清晰度、感觉统合功能）,控制研究时间段为2020年6月-2021年6月。结果比较各组观察指标发现,研究组临床总有有效率明显高于对照组,各项口部运动功能评分均显著高于对照组,构音清晰度评分、感觉统合功能评分明显高于对照组,差异均存在意义,P<0.05。结论 在儿童构音障碍治疗中应用感觉统合训练+口部运动具有显著效果,可促改善构音障碍情况,可促进口部运动功能与感觉统合功能提高,具有理想的治疗价值,可推广。     

杓状软骨运动的三维仿真

目的:探讨杓状软骨的运动特点.方法:通过分析杓状软骨在环杓关节面的运动轨迹,利用Pro/ENGINEER(Pro/E)软件对环状软骨、杓状软骨及声带进行模拟三维重建动画仿真.结果:三维模拟动画形象表现声带的运动形态及杓状软骨脱位时声带运动特点.结论:该三维模型对临床上杓状软骨运动障碍性疾病的诊治有一定的指导意义.     

颞骨内面瘫面肌支配神经运动点的易伤性

本文应用ＳＥＭ—４２０１型神经兴奋测试仪，对国人额肌、眼肌、口肌进行测试，得出各肌强度—时间曲线的正常阈值。通过各肌间阈值对比，得出眼肌阈值＜额肌阈值＜口肌阈值的结果，即眼支运动点兴奋性最大，最易受损伤。又对１６５例面瘫病人进行测试发现，眼肌失神经支配最多、程度最重     

面瘫患者健侧面部动静态指标的三维测量分析

目的基于面部三维动态定量分析系统(3-Dimensional Analysis System for Facial Motion,3D-ASFM)对健康受试者及面瘫患者健侧面部测量,探讨面瘫后健侧面部静态和动态指标的变化。方法纳入23例单侧面瘫患者,匹配年龄相当的健康受试者作为对照。同时纳入74例不同年龄段的单侧面瘫患者。对所有受试者均进行面部主观评估(House-Brackmann分级和Sunnybrook评分)和面部三维动态测量。比较面瘫患者健侧面部动静态指标与正常人面部指标的差异。分析健侧指标是否受年龄、性别、面瘫程度及侧别等影响。结果面瘫患者健侧静态指标各数值均大于正常人。部分动态指标为面瘫组大于对照组,余指标未见明显统计学差异。与对照组相比,面瘫后男女间上下睑间距差异更明显,但动态指标无显著性差异。健侧除了鼻唇沟宽度与年龄有一定正相关性外,余指标未明显受年龄影响。不同面瘫侧别患者健侧指标无显著性差异。面瘫的程度与健侧指标无明显相关性。结论面瘫之后,患者健侧面部无论是静态还是运动均会发生改变,大部分改变与面瘫程度、年龄、性别、侧别等无关。     

健康中国人面部动静态对称性研究

目的利用已建立的基于动作捕捉的面部运动三维动态定量分析系统(3-D ASFM)定量分析正常人面部运动,比较面部对称性,为进一步客观评估面瘫患者面肌功能提供参考。方法无偿招募28名志愿者。标记观察点,利用基于动作捕捉的面部运动三维动态定量分析系统进行面部的静态及动态采集、重建及分析。比较受试者面部静态及动态双侧差异。结果面部存在不对称性,虽然所纳入的受试者均为右利手,但统计结果未发现面部运动的优势侧,同一个体面部不同区域活动优势侧并不一致。静态指标中除双侧鼻小柱—鼻翼距离存在统计学差异外,其余面部静态指标无显著性差异。动态测量呲牙动作时,左右口角最大移动距离具有统计学差异(P<0.05),左侧移动距离较右侧平均多1.23mm。余指标未发现统计学差异。结论证实面部不对称性普遍存在,人群中不存在面部运动半侧优势。     

Objective Facial Motion Analysis in Patients With Facial Nerve Dysfunction

Objectives/Hypothesis To objectively measure facial motion at various facial landmarks using a video‐computer interactive system. Study Design Clinical, prospective, non‐randomized. Methods A video‐computer interactive system, The Peak Motus Motion Measurement System, was used to study linear displacement at preselected facial landmarks in the normal and abnormal face. Subjects with normal facial function (n = 34) and patients with abnormal facial function (n = 26) from various etiologies were studied. The sites studied were marked with reflective beads. Of a larger repertoire of expressions, two expressions (eyes closed and closed‐lip smile) were studied in all subjects. The percent asymmetry in facial displacement between the sides of the face was calculated. The sensitivity of this measurement to facial dysfunction was evaluated. The presence of synkinesis was examined by quantifying the displacement at facial sites that were remote to the sites primarily involved in a given facial expression. Test–retest reliability of the percent asymmetry measurement was evaluated with the paired t test. Results The video‐computer interactive approach used accurately detected and quantified gross and subtle changes in facial function. The sensitivity of the percent asymmetry measurement was 95% (both expressions) for patients with apparent facial dysfunction (House‐Brackmann rating >I/VI). In patients with facial nerve dysfunction, displacement on the presumably normal side was significantly excessive in 27% to 35%, depending on the expression. With this interactive computer‐video system, synkinesis was detected in 58% of the pathologic subjects during the eyes closed or closed‐lip smile expressions. The paired t test indicated strong test–retest reliability (r = 0.73–0.99) of the percent asymmetry measurement. Conclusions The present report indicates that this approach to the assessment of facial motion is sensitive to facial dysfunction. This computer‐video interactive system is able to quantify synkinesis. A grading system for the magnitude of synkinesis, based on the magnitude of the displacement at remote facial sites, is proposed. The common occurrence of excessive facial motion on the presumably normal side of affected individuals indicates that patients with facial paralysis often overcompensate by exaggerating the normal side in an effort to move the affected side. This system is of value in the objective measurement of normal facial function and may prove a useful tool to quantify the outcomes of various medical and surgical treatments for facial nerve dysfunction.     

Candidal Abscess of the Parotid Gland Associated with Facial Nerve Paralysis

Facial nerve paralysis associated with parotid gland mass is usually caused by malignant neoplasms and facial nerve dysfunction due to parotid infection is exceedingly rare. A review of the literature revealed &#44 15 cases of facial nerve palsy associated with suppurative parotitis or parotid abscess. We report the first case of candidal abscess of the parotid gland associated with facial nerve paralysis in a 74-year-old insulin-dependent diabetic patient. The differential diagnosis in these unusual cases occurring in diabetic, immunodeficient patients should include Candida albicans infection.     

保留面神经的颞骨内面神经鞘瘤手术

目的探讨颞骨内面神经鞘瘤,手术切除肿瘤保留面神经的可能性及其临床特征。方法回顾分析2例保留面神经的颞骨内面神经鞘瘤病例资料,分析其临床表现,影像特点,术中发现及面神经功能预后情况。结果 2例患者主要表现为耳部胀痛,听力下降;术前面神经功能正常,均接受手术治疗,术中发现肿瘤位于面神经垂直段及部分颞骨外段,肿瘤包绕神经,剥离肿瘤后神经解剖结构基本得到保存,术中快速冰冻及术后病理均证实为神经鞘瘤。术后面神经功能均为HB-III级。结论对于术前没有明显面瘫的颞骨内的面神经鞘瘤,存在手术剥离肿瘤保留神经的可能,且术后面神经功能能很好保留。     

Facial nerve hemangiomas: A review

Facial nerve hemangiomas are rare benign vascular tumors with primary symptoms including progressive facial nerve palsy and hearing loss. They can involve various segments of the facial nerve, especially the geniculate ganglion (G.G.). Preoperative MRI and CT imagining is of great importance for early diagnosis of such lesions. The most accepted treatment for facial nerve hemangiomas is surgical excision1 and the type of approach depends on tumor location, preoperative hearing level and tumor size. In consideration of the difficulties in differential diagnosis, otologists should pay attention to avoid missed or incorrect diagnosis in hemangiomas of facial nerve.