title: Measuring attentional bias to peripheral facial deformities.
abstract: OBJECTIVE
  Introduce a novel method for objectively evaluating attentional bias to peripheral facial deformities using an established metric of attention.
  
  
  METHODS
  The SMI eye-tracker system (SensoMotoric Inc., Boston, MA) was used to record the eye movement patterns, called scanpaths, of eight naïve observers gazing at pictures of faces with or without peripheral surgical deformities. The scanpaths of observers gazing on those novel faces were compared, and the fixation durations for different facial regions were compared between faces.
  
  
  RESULTS
  There were statistically significant differences in the mean fixation times between the faces considered normal and those considered abnormal (those with an obvious defect). When multivariate analysis of variance was performed with dependent variables total fixation time, fixation time in central triangle, and fixation time in the defect region and the independent variable face, all four tests were highly statistically significant. When univariate analysis of variance was performed to test the hypothesis that defect fixation times varied by face, the results were highly statistically significant (F = 8.79, P = .0003).
  
  
  CONCLUSIONS
  Observers gazing on faces typically focus their attention on discriminating features, such as eyes, nose, and mouth. The well-established method of eye movement recordings was applied in a novel way to provide quantitative data showing changes in observer gaze patterns to focus on deformities. These gaze patterns are a direct reflection of observer attention. This is the first objective method to quantify the amount of distraction caused by peripheral facial deformities and may provide insight into the perception of facial deformity.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland 21287, USA. learnes2@jhmi.edu
authors.forename: Lisa
authors.initials: L
authors.lastname: Ishii
authors.forename: John
authors.initials: J
authors.lastname: Carey
authors.forename: Patrick
authors.initials: P
authors.lastname: Byrne
authors.forename: David S
authors.initials: DS
authors.lastname: Zee
authors.forename: Masaru
authors.initials: M
authors.lastname: Ishii
mesh_terms: D001288:Attention / Q000502:physiology*; D005133:Eye Movements / Q000502:physiology*; D005146:Facial Asymmetry / Q000503:physiopathology* / Q000523:psychology; D005149:Facial Expression; D005260:Female; D005403:Fixation, Ocular / Q000502:physiology*; D006801:Humans; D008297:Male; D010364:Pattern Recognition, Visual / Q000502:physiology*; D015203:Reproducibility of Results