Introduction
Outcomes assessment in face transplantation is necessary to provide evidence in support of this live-giving surgery Current methods, however, are imprecise or prone to subjectivity Software-based video analysis allows for fast, objective and retrospective assessment of the functions related to facial movement and expression of emotions
Patients and methods
We recorded standard electronic videos of each of our 7 face transplant recipients before as well as every 3 to 6 months after transplantation Each video consists of a patient performing a standard sequence of facial movements We retrospectively analyzed all videos using a customized software (Affdex, iMotions, Boston, MA) that automatically tracks and measures the magnitude and direction of facial movements and expressions by recognizing 24 standard reference anatomical points in the face Subsequently, we compared the measurements obtained for a particular patient with those obtained for the same patient at different time points to assess facial motion recovery
Results
After a mean follow up of 35 years, every patient had showed significant improvements in facial motor function when compared with pre transplant time points Significant improvements were first observed after an average of 6 months after transplantation In 3 patients with partial face transplants, the extent and quality of motor function of the transplanted parts of the face did not show any significant differences compared to the unaffected part 1 y after transplantation
Conclusion
Software based video analysis provides the first assessment tool capable for objective, precise and reproducible analysis of facial motor and expressive function after face transplantation Of note, this software works with conventional camera and computer equipment, making widespread use possible Standardized lightning conditions and patients' compliance with performing the facial motor tasks are required to achieve comparable results.