Pouwels Sjaak, Ingels Koen, van Heerbeek Niels, Beurskens Carien
Department of Facial Plastic Surgery, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands,
Eur Arch Otorhinolaryngol. 2014 Sep;271(9):2517-21. doi: 10.1007/s00405-013-2790-8. Epub 2013 Oct 31.
There have been several studies in the past depicting asymmetry in 'normal' human faces. Evidence supports the fact that the right hemisphere is superior in the recognition of emotions expressed by the human face and indicates a right hemispheric specialization for processing emotional information. The primary aim of this study is to determine whether there is a difference in cosmetic appreciation of a left peripheral facial palsy compared to a right peripheral facial palsy? Pictures of patients with a facial palsy with House-Brackmann II-VI were reversed as a mirror image and offered as a pair of pictures, together with the true image. Forty-two patients and 24 medical professionals familiar with facial palsy were asked to choose the most attractive photograph. The primary 'end' point was the most attractive side in the pictures chosen by medical professionals and patients. The secondary 'end' points consisted of the preferences for the mirror or true image, and influences of the House-Brackmann score and age. Medical professionals preferred the photographs from patients with a right and left peripheral facial palsy (PFP) in, respectively, a mean of 44 % (41-48 %) and 56 % (52-59 %) of the pictures (p = 0.02). When comparing mirror and true image, patients with a left-sided facial palsy chose their mirror and true image as most attractive in 90 and 10 %, respectively (p < 0.05). Patients with a right-sided facial palsy chose their mirror and true image in 30 and 70 %, respectively (p > 0.05). Subanalysis of patients with a PFP House-Brackmann score V and VI showed that medical professionals did not have a significant preference for a left nor right-sided facial palsy. Patients with a left-sided facial palsy chose their mirror image in all cases and patients with a right-sided palsy chose their mirror and true image in resp. 33 and 67 %. The House-Brackmann score (p = 0.52) and age (p = 0.73) of the patients did not influence preferences. This study, demonstrating that medical professionals find a right-sided facial palsy cosmetically less attractive than a left-sided, has clinical relevance. Patients, especially with a left-sided facial palsy, tend to choose for their mirror image, although this choice seems to be influenced by hemispheric specialization and familiarity.
过去已有多项研究描绘了“正常”人脸的不对称性。有证据支持这样一个事实，即右半球在识别人脸所表达的情感方面更具优势，这表明右半球在处理情感信息方面具有特殊性。本研究的主要目的是确定与右侧周围性面瘫相比，左侧周围性面瘫在美容评价上是否存在差异？将患有House-Brackmann II-VI级面瘫的患者照片镜像翻转后作为一对图片呈现，同时展示真实图像。42名患者和24名熟悉面瘫的医学专业人员被要求选择最具吸引力的照片。主要“终点”是医学专业人员和患者所选图片中最具吸引力的一侧。次要“终点”包括对镜像或真实图像的偏好，以及House-Brackmann评分和年龄的影响。医学专业人员分别在平均44%（41%-48%）和56%（52%-59%）的图片中更喜欢右侧和左侧周围性面瘫（PFP）患者的照片（p = 0.02）。在比较镜像和真实图像时，左侧面瘫患者分别有90%和10%选择其镜像和真实图像为最具吸引力（p < 0.05）。右侧面瘫患者分别有30%和70%选择其镜像和真实图像（p > 0.05）。对House-Brackmann评分V级和VI级的PFP患者进行亚分析显示，医学专业人员对左侧或右侧面瘫均无明显偏好。左侧面瘫患者在所有情况下均选择其镜像，右侧面瘫患者分别有33%和67%选择其镜像和真实图像。患者的House-Brackmann评分（p = 0.52）和年龄（p = 0.73）不影响偏好。本研究表明医学专业人员发现右侧面瘫在美容方面不如左侧面瘫有吸引力，具有临床相关性。患者，尤其是左侧面瘫患者，倾向于选择其镜像，尽管这种选择似乎受半球特殊性和熟悉程度的影响。
