Artificial intelligence-based numerical analysis of the quality of facial reanimation: A comparative retrospective cohort study between one-stage dual innervation and single innervation |
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| Affiliation: | 1. Department of Plastic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea;2. Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea;3. Department of Electronic Engineering, Kwangwoon University, Seoul, South Korea;4. Graduate School of Smart Convergence, Kwangwoon University, Seoul, South Korea;1. Univ. Angers, CHU Angers, Department of Oral and Maxillofacial Surgery, 49000, Angers, France;2. Univ. Bordeaux, CHU Bordeaux, Inserm, Department of Oral and Maxillofacial Surgery, U 1026 – Bioengineering of Tissues, F-33000, Bordeaux, France;3. Maxillo-Facial Surgery Department, Amiens-Picardie University Hospital, 80000, Amiens, France;4. Department OMFS, Department Imaging and Pathology, Faculty of Medicine, Leuven University Hospitals, Leuven, Belgium;5. Department of Pathology, Lille University Hospital, Lille, France;6. Inserm, CNRS, UMR9020, U1277 - CANTHER - Cancer Heterogeneity, Plasticity and Resistance to Therapies, University of Lille, Lille University Hospital, F-59000, Lille, France;7. Univ. Lille, CHU Lille, Inserm, Department of Oral and Maxillofacial Surgery, U 1008 - Controlled Drug Delivery Systems and Biomaterials, F-59000, Lille, France;8. ENT and Head and Neck Department, Lille, 59037, Cedex, France;9. University Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, Lille, F-59000, France;10. Univ. Bordeaux, CHU Bordeaux, Department of Oral and Maxillofacial Surgery, F-33000, Bordeaux, France;11. Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium;1. Cleft and Craniofacial SA, Women''s and Children''s Hospital, North Adelaide, South Australia, Australia;2. Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand;3. Biomechanics Research Center, Meticuly Co. Ltd., Chulalongkorn University, Bangkok, Thailand;4. Advanced Materials Analysis Research Unit, Department of Metallurgical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand;5. Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand;6. Department of Neurosurgery, Women''s and Children''s Hospital, North Adelaide, South Australia, Australia;1. Department of orthopedic surgery, Chung-Ang university hospital, Chung-Ang university college of medicine, Seoul, Corée;2. Trauma center, department of thoracic & cardiovascular surgery, Dankook university hospital, Corée;3. Orthopedic trauma division, trauma center, Gachon university college of medicine, Incheon, Corée;1. The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China;2. Department of Orthognathic & Cleft Lip and Palate Plastic Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China;3. Department of Stomatology, Renmin Hospital, Hubei University of Medicine, Shiyan, China;4. Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China |
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| Abstract: | This study aimed to investigate the difference in facial reanimation surgery using functional gracilis muscle transfer between the masseteric nerve alone and its combined use with cross face nerve graft (CFNG), which has not been explored before. A novel analysis method based on artificial intelligence (AI) was employed to compare the outcomes of the two approaches.Using AI, 3-dimensional facial landmarks were extracted from 2-dimensional photographs, and distance and angular symmetry scores were calculated. The patients were divided into two groups, with Group 1 undergoing one-stage CFNG and masseteric nerve dual innervation, and Group 2 receiving only masseteric nerve. The symmetry scores were obtained before and 1 year after surgery to assess the degree of change.Of the 35 patients, Group 1 included 13 patients, and Group 2 included 22 patients. The analysis revealed that, in the resting state, the change in the symmetry score of the mouth corner showed distance symmetry (2.55 ± 2.94, 0.52 ± 2.75 for Group 1 and Group 2, respectively, p = 0.048) and angle symmetry (1.21 ± 1.43, 0.02 ± 0.22 for Group 1 and Group 2, respectively, p = 0.001), which were significantly improved in Group 1, indicating a more symmetric pattern after surgery. In the smile state, only the angle symmetry was improved more symmetrically in Group 1 (3.20 ± 2.38, 1.49 ± 2.22 for Group 1 and Group 2, respectively, p = 0.041).Within the limitations of the study it seems that this new analysis method enabled a more accurate numerical symmetry score to be obtained, and while the degree of mouth corner excursion was sufficient with only the masseteric nerve, accompanying CFNG led to further improvement in symmetry in the resting state. |
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| Keywords: | Cross face nerve graft Dual innervation Facial palsy Facial reanimation Masseteric nerve Numerical approach |
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