Living with the effects of Bell’s palsy is a frustrating experience. This frustration is compounded by the fact that most treatments don’t work well and patients can’t be sure when the symptoms will subside. These facts make it frustrating for the physicians who care for patients with Bell’s palsy, too.
But what if we had a better understanding of the course of the disease—a map of the typical pathways to resolution? Could this map be used to predict disease course and response to treatment? If so, we perhaps could relieve some of the stress for affected patients by outlining a probable timeline of symptoms, and we could tailor treatment based on likely response.
This may sound like a stretch right now, but one lab is working on just such a map. The Facial Animation Lab is led by Carroll Ann Trotman, Professor and Chair of Orthodontics at Tufts School of Dental Medicine. Initial research in the lab focused on mapping for cleft lip and cleft palate surgery with the hope of providing “surgeons with a tool to more accurately assess the extent of impairment and degree of disfigurement, and ultimately tailor revision surgeries to a patient’s individual needs.”
Now the lab has turned its 3-D cameras toward 34 patients with facial paralysis, specifically Bell’s palsy. The patients are fitted with a grid of reflective markers and then directed through a series of facial movements which are recorded by the cameras. This is repeated multiple times over 12 weeks and then the 3-D images are animated, providing a window into the recovery of individual patients and an opportunity to analyze similarities and differences among patients.
Trotman has also designed the study, funded by the National Institute of Dental and Craniofacial Research, to assess the ways patients cope with the emotional impact of facial paralysis throughout their recovery. Her hope is that physicians armed with the study results will be more equipped to care for patients with all aspects of facial paralysis, from the physical symptoms to the psychological effects.
It’s easy to imagine the potential of this type of information. As this study is completed and used to develop further research protocols, can specific pathways of recovery be identified? Do certain characteristics make a patient more likely to respond well to certain treatment types? Can these methods be used to learn more about other disorders such as focal dystonias?
Time will tell. But at the very least this research can arm patients and their physicians with more specific information about the course of the disease and its recovery. Even if it doesn’t lead to improvements in treatment, it may help reduce the frustration of not understanding what is happening for the patient. That in itself is good medicine.