Abstract: Background: Photography and video are necessary to record the severity of a facial palsy or to allow offline grading with a grading system. There is no international standard for the video recording urgently needed to allow a standardized comparison of different patient cohorts. Methods: A video instruction was developed. The instruction was shown to the patient and presents several mimic movements. At the same time the patient is recorded while repeating the presented movement using commercial hardware. Facial movements were selected in such a way that it was afterwards possible to evaluate the recordings with standard grading systems (House-Brackmann, Sunnybrook, Stennert, Yanagihara) or even with (semi)automatic software. For quality control, the patients evaluated the instruction using a questionnaire. Results: The video instruction takes 11 min and 05 and is divided in three parts: 1) Explanation of the procedure; 2) Foreplay and recreating of the facial movements; 3) Repeating of sentences to analyze the communication skills. So far 13 healthy subjects and 10 patients with acute or chronic facial palsy were recorded. All recordings could be assessed by the above mentioned grading systems. The instruction was rated as well explaining and easy to follow by healthy persons and patients. Discussion: There is now a video instruction available for standardized recording of facial movement. This instruction is recommended for use in clinical routine and in clinical trials. This will allow a standardized comparison of patients within Germany and international patient cohorts.

Abstract: In the field of otorhinolaryngology, the dysfunction of the facial nerve is a common disease which results in a paresis of usually one half of the patients face. The grade of paralysis is measured by physicians with rating scales, e.g. the Stennert Index or the House-Brackmann scale. In this work, we propose a method to analyse and predict the severity of facial paresis on the basis of single images. We combine feature extraction methods based on a generative approach (Active Appearance Models) with a fast non-linear classifier (Random Decision Forests) in order to predict the patients grade of facial paresis. In our proposed framework, we make use of highly discriminative features based on the fitting parameters of the Active Appearance Model, Action Units and Landmark distances. We show in our experiments that it is possible to correctly predict the grade of facial paresis in many cases, although the visual appearance is strongly varying. The presented method creates new opportunities to objectively document the patients progress in therapy.