[Image analysis system for detection facial paralysis]. / Bildanalysesystem zur Erkennung einer Fazialisparese.

BACKGROUND: Evaluation of facial nerve paresis depends on visual assessment and naturally differs from examiner to examiner. An objective measurement instrument is presented. PATIENTS AND METHOD: Facial features are automatically localized by a parametric face model in videos of a face during relaxation and exercises. Gray-level information is analyzed by a special steerable filter and used to identify symmetries. The computer system was tested in 19 individuals. RESULTS: Automatic localization of facial features such as the upper arc of the head and ears was correct in 95%, the eyes in 82%, and the mouth in 73%. Lid paresis was correctly recognized in seven of ten (70%) and oral paresis in 10 of 12 (83%) cases. Unaffected eyelid movements were identified in eight of nine (89%) and healthy oral regions in all seven (100%) cases. CONCLUSION: The computer system presented is able to automatically localize facial features and to identify facial nerve paresis. It is a considerable step toward automatic and objective grading of facial nerve paresis.

Bilateral mucosa-associated lymphoid tissue lymphoma of the parotid gland.

Mucosa-associated lymphoid tissue (MALT) tumors of the parotid gland are extranodal non-Hodgkin lymphomas. Stage I and II MALT tumors are usually treated with surgery or radiotherapy. Bilateral MALT-derived non-Hodgkin lymphoma of the parotid glands is rare, and optimal treatment is debatable. Two patients presented at the otorhinolaryngology department of the Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany. The treatment strategy that was used in case 1 was also successfully used in case 2. A precise diagnosis could not be made by either fine-needle biopsy or intraoperative frozen section biopsy; it was achieved with open biopsy. Surgery and/or radiotherapy proved to be effective. There was no recurrence of disease in either case. The advantages of surgery are complete resection of the tumor and absence of xerostomia and mucositis, which are caused by irradiation. Radiotherapy does not produce a scar or an indentation at the parotid region, however, and results in a better cosmetic appearance. Therefore, we recommend open biopsy with facial nerve monitoring and subsequent irradiation in cases in which bilateral prominence of the parotid glands and suspicion of a MALT lymphoma are both present.