Facial Nerve Database: Clinical Approaches & Outcomes in Facial Paralysis Management
Facial paralysis is a debilitating condition that generates both physical and social impairments. Our goal is to expedite treatment and recovery for each patient. The Facial Nerve Database allows us to document and understand the complexities of each unique facial paralysis case. Utilizing comparative analysis allows us to assess trends between patients’ etiology, treatment, and their functional outcomes, which may lead to novel treatment paradigms for future patients. Herein, our focus is to examine our everyday clinical approaches of patients with facial paralysis and to investigate whether interventions actually translate into better facial function and improved quality of life.
Our goal is to provide patients with the highest level of quality medical care and the best possible patient experience. In order to consistently meet and exceed national standards for clinical care, we constantly examine the efficacy of a variety of our clinical approaches. Patient feedback through survey data is an essential part of our research and clinical management. Administering several validated surveys allows us to assess whether certain interventions have a meaningful impact on improving overall facial function and patient quality of life.
The Facial Grading Scale and the Synkinesis Questionnaire assesses aberrant movement in a patient’s face after receiving physical therapy and botulinum toxin treatment, respectively. The FACE Instrument, completed by the patient, measures quality of life with respect to facial paralysis and benefits our entire patient population. Finally, our novel E-FACE clinical tool offers nominal real-time measures of a patient’s paralysis. This easy-to-understand graphic output allows for ease of use by the clinician, understanding for the patient, and historical tracking of progress of recovery over time.
Furthermore, the “big data” collected by our survey program allows our research scientists the ability to ascertain correlations which may have otherwise been overlooked. Tracking each treatment outcome, with the collection of survey data, is just one of the ways we continue to improve patient care offered at the Facial Nerve Center at Mass Eye and Ear.
Bionic Face: A Facial Pacing System
In the future, a facial pacing system may be an option for patients experiencing unilateral facial paralysis. The system records healthy-side facial movements, performs computer translation of the signal, and delivers stimuli which elicit movement of the paralyzed face. The development of a facial pacing system is on the horizon and we have published our initial finding here and here.
Surgical Management of Facial Nerve Injury
Measuring rodent facial movements is a reliable method for studying recovery from facial nerve manipulation and for examining the behavioral correlates of aberrant regeneration. We quantitatively compare recovery of vibrissal and ocular function following three outcome measures clinically relevant to nerve injury.
To date, our work has yielded insight into the normal rodent facial function and has provided information related to the rate and degree of recovery after nerve injury and repair. In the future, we plan to test potential treatments using this model and hope to contribute to the discovery of novel methods to treat our patients suffering from facial nerve disorders.
Advanced Neural Conduit Repair
The use of donor nerves is common during facial reanimation surgery. A potential pitfall when using nerve donors can be there minimal supply. This study involves the implantation of tubular conduits as replacements for donor nerves across nerve gaps in the rat. Following implantation, animals are monitored during the 10-week recovery period. Functional recovery outcome data is measured via quantitative histologic and functional parameters. The production of an implantable nerve conduit is paramount for tissue engineering and all reanimation surgery where a gap is present during nerve re-approximation.
Bionic Facial Pacing
Recent breakthroughs in technology around the development of bionic control of limb prostheses have led to excitement and promise in the future management of facial paralysis. We believe these advancements can be applied to the gamut of facial movement disorders. The system we propose would record healthy-side facial movements, perform computer translation of that signal, and deliver stimuli which elicit movement of the paralyzed face. The Facial Nerve Regeneration Laboratory is currently designing experiments to study the feasibility of such a device.