Introduction of a Low-Cost and Automated Four-Dimensional Assessment System of the Face.

Existing automated objective grading systems either fail to consider the face's complex three-dimensional morphology or have poor feasibility and usability. Consumer-based red, green, and blue depth sensors or smartphone integrated three-dimensional hardware can inexpensively collect detailed four-dimensional facial data in real time but are yet to be incorporated into a practical system. This study aimed to evaluate the feasibility of a proof-of-concept automated four-dimensional facial assessment system using a red/green/blue depth sensor (OpenFAS) for use in a standard clinical environment.

Gene expression profiling of perineural invasion in head and neck cutaneous squamous cell carcinoma.

Perineural invasion (PNI) is frequently associated with aggressive clinical behaviour in head and neck cutaneous squamous cell carcinoma (HNcSCC) leading to local recurrence and treatment failure. This study evaluates the gene expression profiles of HNcSCC with PNI using a differential expression analysis approach and constructs a tailored gene panel for sensitivity and specificity analysis. 45 cases of HNcSCC were stratified into three groups (Extensive, Focal and Non PNI) based on predefined clinicopathological criteria.

Three-dimensional scanners for soft-tissue facial assessment in clinical practice.

Introduction: The quantitative assessment of facial appearance and function is critical in the process of restoring normality and thus minimising morbidity in patients with facial deformities. Three-dimensional (3D) scanners have increasingly been applied in clinical settings to circumvent the issues associated with standard approaches, namely, subjectivity. This study aimed to summarise the current literature on the accuracy, reliability, and usability of 3D scanning technologies for soft-tissue facial assessment.

Dual chimeric innervated vastus lateralis free flap for single stage blink and midface reanimation.

Background: The immediate reconstruction of the face in the setting of radical parotidectomy for malignancy represents a particular challenge. We present a novel technique using 2 sections of the vastus lateralis muscle as a chimeric flap in combination with the anterolateral thigh (ALT) fasciocutaneous flap to achieve midface reanimation and eye closure after radical parotidectomy.

Methods: The harvest technique in view of variations in chimeric muscle components, vascular pedicles, and neural coaptations is described herein.

Altered axonal excitability properties in facial palsy.

Introduction: Axonal excitability measures give insight into the biophysical properties of peripheral nerve axons. In this study we applied these techniques to the study of facial palsy.

Methods: Thirty patients with established facial palsy due to unresolved Bell's palsy or herpes zoster (>6 months duration), tumor invasion of the facial nerve, or traumatic facial nerve injury were assessed using facial nerve excitability techniques.

Validation of the Clinician-Graded Electronic Facial Paralysis Assessment.

Background: Facial paralysis remains a debilitating condition despite advances in medical, surgical, and adjunctive interventions. Established grading systems used to assess facial paralysis and interventional outcomes have well-described limitations. The Electronic Facial Paralysis Assessment, a clinician-graded zone-based facial function scale, has recently emerged as a grading tool that may provide greater sensitivity when assessing incomplete paralysis and postsurgical improvement.

Single innervated segmented vastus lateralis for midfacial reanimation during radical parotidectomy.

Background: Innervated free muscle transfer using the gracilis muscle or temporalis myoplasty has been successfully utilized for facial reanimation in chronic facial palsy. These techniques are less suited to immediate facial reconstruction in the setting of radical parotidectomy, in which the complexity of the defect, patient age, postoperative radiotherapy, and limited life expectancy pose particular challenges.

Methods: We present a novel description of the use of a chimeric anterolateral thigh (ALT) flap and innervated vastus lateralis to achieve midface static suspension and dynamic reanimation in the setting of radical parotidectomy.

Assessment of axonal excitability properties in two branches of the human facial nerve.

Background: Axonal excitability methods have an established role in determining the biophysical properties of human axons in the clinical setting. The translation and refinement of these techniques for application to the facial nerve is important for advancing the pathophysiological understanding of facial nerve disorders. Facial nerve disorders are common and debilitating, yet in most cases diagnosis is based on clinical judgment alone.

Reconstruction of limited parotidectomy defects using the dermofat graft.

Background: Removal of part or all of the parotid gland may leave a visible contour defect and may also be associated with complications such as Frey's syndrome. These aesthetic and functional issues can be addressed using dermofat graft reconstruction. The aim of this study is to assess patient satisfaction and complications associated with using the dermofat graft for contour restoration in patients undergoing parotidectomy.

Diagnostic and prognostic utility of Mastermind-like 2 (MAML2) gene rearrangement detection by fluorescent in situ hybridization (FISH) in mucoepidermoid carcinoma of the salivary glands.

Objective: Mucoepidermoid carcinoma (MEC) is the most common salivary gland malignancy, with a proportion harboring MAML2 rearrangement. This study evaluates the diagnostic and prognostic utility of MAML2 rearrangement in MEC.

Study Design: Salivary gland malignancies at a single institution (1989-2014) were reviewed to identify MECs.

Salivary duct carcinoma: Clinicopathologic features, morphologic spectrum, and somatic mutations.

Background: Accurate diagnosis of salivary duct carcinoma requires a high index of suspicion and clinicopathologic correlation. Hallmark genetic changes that may provide novel therapeutic options are being explored.

Methods: One hundred ninety salivary gland malignancies at Royal Prince Alfred Hospital (from 1989-2014) were reviewed.

Mammary analogue secretory carcinoma: an evaluation of its clinicopathological and genetic characteristics.

Mammary analogue secretory carcinoma (MASC) is a recently described salivary gland malignancy. We evaluate the clinicopathological characteristics and long-term clinical behaviour of MASCs. A total of 190 primary salivary gland malignancies at a single institution were reviewed along with relevant immunohistochemical and fluorescent in situ hybridisation (FISH) studies to identify MASCs.

Parotidectomy: surgery in evolution.

Background: Approximately 15 years ago, Bron and O'Brien described a large Australian series of 248 patients focusing on facial nerve function post parotidectomy performed by a single surgeon over an 8-year period. The primary aim of this study was to assess changes in pathology, surgical approach and outcomes following parotidectomy in a comparable single surgeon series from the same institution.

Methods: Details of patients undergoing parotidectomy by, or under the supervision of, the senior author (JRC) between February 2006 and December 2013 were retrospectively reviewed.

Bell's palsy: aetiology, clinical features and multidisciplinary care.

Bell's palsy is a common cranial neuropathy causing acute unilateral lower motor neuron facial paralysis. Immune, infective and ischaemic mechanisms are all potential contributors to the development of Bell's palsy, but the precise cause remains unclear. Advancements in the understanding of intra-axonal signal molecules and the molecular mechanisms underpinning Wallerian degeneration may further delineate its pathogenesis along with in vitro studies of virus-axon interactions.