Video-Based Facial Movement Analysis in Facial Paralysis

Primary outcomes

1. Agreement Between Video-Based Objective Facial Motion Analysis and Clinical Facial Assessment Scale Scores

   Time frame: Single assessment session (Day 1)

   The degree of agreement/correlation between facial movement parameters obtained from video-based objective analysis and scores obtained from standardized clinical facial assessment scales, evaluated during the same session.

2. Sunnybrook Facial Grading System

   Time frame: Baseline

   The Sunnybrook Facial Grading System (SFGS) is a clinician-rated outcome measure used to assess facial nerve function in individuals with facial paralysis. The scale evaluates three components: resting facial symmetry, voluntary facial movement, and synkinesis. Resting symmetry is assessed in the eye, cheek (nasolabial fold), and mouth regions, while voluntary movement is evaluated during five standardized facial expressions. Synkinesis is scored based on the presence and severity of involuntary associated movements during voluntary facial tasks. The composite score is calculated using the standard Sunnybrook scoring formula and ranges from 0 to 100, where 0 indicates complete facial paralysis with severe asymmetry and synkinesis, and 100 indicates normal facial function without asymmetry or synkinesis. Higher scores represent better facial nerve function.

3. FDI (Facial Disability Index):

   Time frame: Baseline

   The Facial Disability Index (FDI) is a patient-reported outcome measure used to assess the impact of facial paralysis on physical function and social well-being. The questionnaire consists of 10 items divided into two subscales: Physical Function (5 items) and Social/Well-being Function (5 items). Each subscale is transformed to a score ranging from 0 to 100, with higher scores indicating better function, less disability, and better health-related quality of life. Participants complete the questionnaire independently according to their perceived level of facial disability.

4. House-Brackmann Facial Grading System (HBGS)

   Time frame: Baseline

   The House-Brackmann Facial Grading System (HBGS), the Sunnybrook Facial Grading System (SFGS), and the Facial Disability Index (FDI) will be used to evaluate facial nerve function and patient-reported disability. HBGS is a clinician-rated six-grade scale assessing the overall severity of facial nerve dysfunction. The Sunnybrook Facial Grading System provides a composite score (0-100) based on resting symmetry, voluntary facial movements, and synkinesis, with higher scores indicating better facial function. The Facial Disability Index is a patient-reported outcome measure consisting of Physical Function and Social/Well-being subscales (0-100), where higher scores indicate less disability and better quality of life.