At the Mount Sinai Medical Center, Drs. Elliott Rose, Peter Taub, Eric Jablonka and Ilya Shnaydman have developed the digitally based RoSE Facial Grading System software program for portable tablets (iPads) and computers to objectively measure smile (facial expression) symmetry in the facial paralysis patient. This software has implications in both diagnostic staging and assessment of efficacy of treatment modalities (reanimation surgery, Botox, physical therapy, acupuncture, etc).
Approximately 127,000 new cases of facial paralysis are diagnosed annually, most of which affect only one side of the face. Current methods of 
diagnosis & evaluation of treatment outcomes depend almost solely on subjective assessment of smile asymmetry (facial expressions) by clinicians or independent evaluators. Various standard facial grading systems (House-Brackman, Sunnybrook, Terzis, Nottingham, etc) are hindered by lack of universality, reproducibility, and interobserver consistency. With the obvious evolution toward computer based facial recognition software (often costly and confined to institutional labs), digital analysis of smile excursion is clearly preferable (and more reproducible) than subjective ratings (skewed by reviewer error and variability). But, a new set of problems (challenges) has emerged: the ability to perform facial analysis conveniently, at a low cost, with minimum expenditure of time, and usage of commonly available equipment.
The RoSE FGS software is user friendly, affordable, time efficient, and can be conveniently used in the office, clinic, and operating room. Initiated by a picture (or downloaded image) of the subject’s face both in repose and smiling, the RoSE (Recognition of Smile Excursion) FGS (Facial Grading System) calculates a global score (% symmetry), specific scores (% lip spread and degree of rotation), and animation scores (commissure excursion distance and angle of excursion) based on identification of selected facial anatomic landmarks. Facial landmarks are identified on the photos by stylus or digital touch. Data is automatically input into the program to calculate the respective parameters comparing the affected side to the normal side (as a control). Initial and sequential photos (post treatment) can be uploaded and stored in an encrypted external database for further review and data analysis. The RoSE FGS is intended to establish baselines of clinical deformity, monitor patient progress, and assist in decision making impacting the surgical management of facial paralysis patients. Ultimately, this data may form the basis for “Best Practice” models in this patient cohort.
Current Development Status
- Fully functioning website
Applications
- Objectively measures degree of facial paralysis and facial symmetry
Advantages
- Higher inter-observer reliability
- Automated scoring process
Publications
- Rose EH. “Aesthetic Restoration of the Severely Disfigured Face in Burn Victims: A Comprehensive Strategy.” Plast Reconstr Surg. 96, p.1573 (1995)
- Taub PJ, Kawamoto HK Jr. “Facial Clefting and Hypertelorism.” In: Mc Carthy JG, Galiano RD, Boutros S, editors. Current Therapy of Plastic Surgery. Philadelphia, Elsevier; (2006)
Patent Status
- No applications currently filed
Contact
Christopher Frenz, PhD
Business Development Analyst
Mount Sinai Innovation Partners | Icahn School of Medicine at Mount Sinai
Phone: 646.605.7316