Facial motion analysis of acid burn victims--development of a new facial motion impairment index.
OBJECTIVE
Evaluation of facial movement is necessary for the assessment of motor deficits and planning reconstructive surgery in facial burns. Clinicians recognise the need for an accurate and reproducible method of functional assessment. We propose a new facial functional impairment index (FFII) for assessing facial motor dysfunction due to severe burn injury and provide inter/intra-patient comparison for documenting rehabilitation.


METHODS
The maximal static response assay (MSRA) was used to compare facial movement in 20 acid burn victims with 20 control subjects. Data compiled from 12 soft tissue landmarks was used to quantify rest and dynamic asymmetry, anatomic and non-anatomic motion and calculate the FMII. The Katz score, Nottingham index and number of affected aesthetic units provided insight into FFII efficacy.


RESULTS
Patients with greater aesthetic disfigurement demonstrated significantly poorer anatomic function (c=0.62; p=0.03) as well as larger global facial functional impairment (c=0.52; p=0.08).


CONCLUSIONS
Acid burns caused severe asymmetry and functional impairment. The FFII is a composite score of global function based on a reproducible method of data collection and it differentiated between acid burn victims and provided objective comparative measures. Software automation, integration of video and 3D data, appropriate graphical and pictorial depiction of variables and measurements, and further research into the accuracy of FFII as a marker of clinical recovery and assessment of function in facial burns, will enhance future clinical applications and potentially aid surgical reconstruction.
Ghani
Samuel
S
Thikhana House, Acid Survivors Foundation, Dhaka, Bangladesh. sghani50@yahoo.co.uk <sghani50@yahoo.co.uk>
Mannan
Ashim
A
Kaucer
Ahmed
A
Sen
Samanta Lal
SL
Clarke
Alex
A
Butler
Peter
P
Cartwright
Annabel
A
D000293:Adolescent; D000328:Adult; D002057:Burns, Chemical / Q000150:complications* / Q000503:physiopathology; D005145:Face / Q000502:physiology; D005146:Facial Asymmetry / Q000139:chemically induced*; D005151:Facial Injuries / Q000139:chemically induced* / Q000503:physiopathology; D005155:Facial Nerve Diseases / Q000139:chemically induced* / Q000503:physiopathology; D005260:Female; D006801:Humans; D009068:Movement / Q000502:physiology*; D011596:Psychomotor Disorders / Q000139:chemically induced / Q000175:diagnosis* / Q000503:physiopathology; D013464:Sulfuric Acids / Q000009:adverse effects
D013464:Sulfuric Acids; C033158:sulfuric acid