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Clinical Endocrinology Feb 2003The importance of facial disfigurement in many diseases necessitates a reliable and valid measure of disfigurement severity for clinical studies. The hypothesis is that...
OBJECTIVES
The importance of facial disfigurement in many diseases necessitates a reliable and valid measure of disfigurement severity for clinical studies. The hypothesis is that a universal concept of disfigurement exists and can be measured in a reliable way. The objectives of this study were to investigate if persons, in particular patients and physicians, can agree on facial disfigurement severity; and to determine the relative contribution of predefined clinical characteristics of patients with Graves' ophthalmopathy (GO) to the overall rating of facial disfigurement severity.
DESIGN
A panel study was carried out in four different panels, each consisting of four members.
PATIENTS
We randomly selected 100 slide pairs of GO patients from four available study populations, involving mild, moderate and severe GO patients (mean age 49 years, 76% female) who were treated with either radiotherapy, sham-irradiation, prednisone or orbital decompression.
MEASUREMENTS
All panel members individually scored the disfigurement severity of 100 GO patients shown on standardized slides on a Visual Analog Scale. In total, 1600 ratings were collected. We calculated within- and between-panel agreement of disfigurement severity and identified determinants of disfigurement.
RESULTS
Agreement within a panel varied from 0.65 to 0.79 and was highest within the panel of ophthalmologists. Between-panel agreement was 0.67 and was highest between ophthalmologists and laypersons. Compared with the global average, patients overrated and endocrinologists underrated disfigurement severity. Female panellists rated the patients, on average, more disfigured than male panellists. Important determinants of disfigurement were eyelid retraction, severe eyelid swelling and proptosis. Their relative importance was consistent across panels and in contrast to current measures of GO severity.
CONCLUSION
Facial disfigurement severity can be measured in a reliable way using panels of panellists. Except for some systematic differences between panellists, facial disfigurement does not seem to be in the eye of the beholder.
Topics: Adult; Attitude of Health Personnel; Endocrinology; Esthetics; Facies; Female; Graves Disease; Humans; Male; Middle Aged; Ophthalmology; Severity of Illness Index
PubMed: 12580935
DOI: 10.1046/j.1365-2265.2003.01695.x -
International Braz J Urol : Official... 2015Here we present the first video demonstration of reduction corporoplasty in the management of phallic disfigurement in a 17 year old man with a history sickle cell...
OBJECTIVE
Here we present the first video demonstration of reduction corporoplasty in the management of phallic disfigurement in a 17 year old man with a history sickle cell disease and priapism.
INTRODUCTION
Surgical management of aneurysmal dilation of the corpora has yet to be defined in the literature.
MATERIALS AND METHODS
We preformed bilateral elliptical incisions over the lateral corpora as management of aneurysmal dilation of the corpora to correct phallic disfigurement.
RESULTS
The patient tolerated the procedure well and has resolution of his corporal disfigurement.
CONCLUSIONS
Reduction corporoplasty using bilateral lateral elliptical incisions in the management of aneurysmal dilation of the corpora is a safe an feasible operation in the management of phallic disfigurement.
Topics: Adolescent; Anemia, Sickle Cell; Aneurysm; Dilatation, Pathologic; Humans; Male; Penis; Priapism; Treatment Outcome; Urologic Surgical Procedures, Male
PubMed: 26005988
DOI: 10.1590/S1677-5538.IBJU.2015.02.33 -
Georgian Medical News Nov 2022The purpose of the study is to characterize irreparable facial disfigurement through the prism of medical science and from the perspective of legal criteria in the...
The purpose of the study is to characterize irreparable facial disfigurement through the prism of medical science and from the perspective of legal criteria in the pre-trial investigation of criminal offenses. The practical basis of the research is the statistical and analytical materials of the Ministry of Internal Affairs of Ukraine and the National Police of Ukraine, the General Prosecutor's Office, the State Judicial Administration of Ukraine for 2016 - 2021 regarding the commission of criminal offenses, namely infliction of grievous bodily harm on the grounds of irreparable facial disfigurement of the victim; summarized data of the study of 50 materials of criminal proceedings based on the specified facts (resolution on the appointment of forensic and other examinations, as well as relevant conclusions), materials of the mass media. As a result of the research, it was established that the medical criteria for irreparable facial disfigurement specified in the legal acts need to be improved due to the wide application and systemic nature of the problems, due to the wide application and systemic nature of the problems, which entail both complication of qualification of the committed act and other difficulties in the process of pre-trial investigation. The studied views of researchers in the area of medical and legal sciences made it possible to substantiate the essence and content of irreparable facial disfigurement not only as a legal criterion, but also as a primarily negative phenomenon in the provision of public health care.
Topics: Humans; Criminals; Ukraine; Forensic Medicine
PubMed: 36701780
DOI: No ID Found -
BMC Medical Imaging Mar 2015Patients with facial cancers can experience disfigurement as they may undergo considerable appearance changes from their illness and its treatment. Individuals with...
BACKGROUND
Patients with facial cancers can experience disfigurement as they may undergo considerable appearance changes from their illness and its treatment. Individuals with difficulties adjusting to facial cancer are concerned about how others perceive and evaluate their appearance. Therefore, it is important to understand how humans perceive disfigured faces. We describe a new strategy that allows simulation of surgically plausible facial disfigurement on a novel face for elucidating the human perception on facial disfigurement.
METHOD
Longitudinal 3D facial images of patients (N = 17) with facial disfigurement due to cancer treatment were replicated using a facial mannequin model, by applying Thin-Plate Spline (TPS) warping and linear interpolation on the facial mannequin model in polar coordinates. Principal Component Analysis (PCA) was used to capture longitudinal structural and textural variations found within each patient with facial disfigurement arising from the treatment. We treated such variations as disfigurement. Each disfigurement was smoothly stitched on a healthy face by seeking a Poisson solution to guided interpolation using the gradient of the learned disfigurement as the guidance field vector. The modeling technique was quantitatively evaluated. In addition, panel ratings of experienced medical professionals on the plausibility of simulation were used to evaluate the proposed disfigurement model.
RESULTS
The algorithm reproduced the given face effectively using a facial mannequin model with less than 4.4 mm maximum error for the validation fiducial points that were not used for the processing. Panel ratings of experienced medical professionals on the plausibility of simulation showed that the disfigurement model (especially for peripheral disfigurement) yielded predictions comparable to the real disfigurements.
CONCLUSIONS
The modeling technique of this study is able to capture facial disfigurements and its simulation represents plausible outcomes of reconstructive surgery for facial cancers. Thus, our technique can be used to study human perception on facial disfigurement.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Computer Simulation; Face; Facial Injuries; Facial Neoplasms; Female; Humans; Image Interpretation, Computer-Assisted; Imaging, Three-Dimensional; Male; Middle Aged; Models, Biological; Preoperative Care; Plastic Surgery Procedures; Reproducibility of Results; Sensitivity and Specificity; Treatment Outcome; Young Adult
PubMed: 25885763
DOI: 10.1186/s12880-015-0050-7 -
Plastic Surgical Nursing : Official... 2009Approximately 10% of the population has a facial disfigurement, such as a scar, blemish, or deformity that severely affects the ability to lead a normal life, and 2 to...
Approximately 10% of the population has a facial disfigurement, such as a scar, blemish, or deformity that severely affects the ability to lead a normal life, and 2 to 3% have a clearly visible blemish. They may experience depressive symptoms due to disfigurement, stressful life events, or other causes. Depression is a painful and costly disorder that is often unrecognized and untreated in specialty practices; it is linked with higher costs of care, lengths of stay, and rates of rehospitalization. Often, these individuals seek plastic surgery to repair the disfigurement, and depressive symptoms are not uncommon preoperatively, perioperatively, and postoperatively. In addition, depressive disorders exist among 20 to 32% of people with a medical disease. Major depression is a recurring and disabling illness that typically responds to treatment with psychotherapy, antidepressants, and social support. Nurses have a major role to play in screening for and detecting depression so it can be evaluated and referred for treatment. Nurses also provide education, psychosocial support, and advocacy for patients with depression. Identifying those with depressed symptoms allows the nurse to recommend treatment, offer referrals, and provide supportive interventions.
PubMed: 19289942
DOI: 10.1097/01.PSN.0000347718.75285.23 -
JAAD International Mar 2023
The impact of skin disfigurement in patients with autoimmune connective tissue disorders on quality of life, willingness-to-pay, and time trade-off: A cross-sectional analysis.
PubMed: 36636102
DOI: 10.1016/j.jdin.2022.10.008 -
Journal of Palliative Care 2014Despite the frequent occurrence of head and neck cancer (HNC) disfigurement, little is known about its psychosocial impact on patients. This study aimed to understand...
Despite the frequent occurrence of head and neck cancer (HNC) disfigurement, little is known about its psychosocial impact on patients. This study aimed to understand the lived experience of disfigurement in HNC and explore what patients considered to be its influences. Fourteen disfigured HNC patients participated in a 45-to-120-minute in-depth, semistructured interview, which was analyzed qualitatively using interpretive phenomenology. A majority of participants (64 percent) were considered to be at an advanced cancer stage (stage III or stage IV). Patients' experiences revolved around the concept of a ruptured self-image (a discontinuity in sense of self). Forces triggering this ruptured self-image created a sense of "embodied angst", in which disfigurement served as a constant reminder of the patient's cancer and associated foundational malaise. Other influences fostered a sense of normalcy, balance, and acceptance. Participants oscillated between these two states as they grew to accept their disfigurement. This study's findings could guide supportive interventions aimed at helping patients face head and neck surgery.
Topics: Adaptation, Psychological; Adult; Aged; Body Image; Female; Head and Neck Neoplasms; Humans; Interviews as Topic; Male; Middle Aged; Self Concept
PubMed: 24826438
DOI: No ID Found -
Frontiers in Endocrinology 2022Graves' orbitopathy (GO) is a complex autoimmune disorder of the orbit that causes the eye to appear disfigured. GO is typically associated with Graves' disease, an... (Review)
Review
Graves' orbitopathy (GO) is a complex autoimmune disorder of the orbit that causes the eye to appear disfigured. GO is typically associated with Graves' disease, an inflammatory autoimmune condition that is caused by thyrotropin receptor autoantibodies. Although our knowledge of the pathophysiology of GO has improved, its exact pathogenesis remains unclear. Some patients suffer from disfigurement, double vision, and even vision loss rather than hyperthyroidism. The disease severity and activity prompt different treatments, as the signs of GO are heterogeneous, so their management can be very complex. Despite medical advances, the first-line treatment for moderate-to-severe active GO is still glucocorticoids, while surgery can be critical for the treatment of chronic inactive GO. Surgery is sometimes required in the acute phase of the disease when there is an immediate risk to vision, such as in dysthyroid optic neuropathy. Most surgeries for GO are rehabilitative and subdivided into three categories: decompression, strabismus repair, and lid surgery. This review is a basic overview of the field, with up-to-date knowledge of the surgical techniques for GO. We review and summarize recent literature on the advances in surgery for GO to provide up-to-date insights on the optimal surgical treatment for GO.
Topics: Humans; Graves Disease; Graves Ophthalmopathy; Hyperthyroidism; Optic Nerve Diseases; Orbit
PubMed: 36824601
DOI: 10.3389/fendo.2022.1080204 -
JAMA Facial Plastic Surgery Jul 2016A universal, health care professional-graded scale for facial assessment would be a useful tool for reporting, comparing, and assessing facial function among patients... (Observational Study)
Observational Study
IMPORTANCE
A universal, health care professional-graded scale for facial assessment would be a useful tool for reporting, comparing, and assessing facial function among patients with facial paralysis.
OBJECTIVES
To correlate scores of an assessment tool, the eFACE scale, with expert-rated facial disfigurement and to determine the relative contributions of facial features to facial palsy-related disfigurement.
DESIGN, SETTING, AND PARTICIPANTS
The eFACE scale yields 15 individual variable scores, in addition to subscores for static, dynamic, and synkinesis elements, and a total score that is based on 100-point scales. Two hundred patients with varying degrees of unilateral facial palsy underwent independent eFACE assessment and assignment of a disfigurement score by 2 facial nerve surgeons. The mean scores were determined, and multivariate regression analysis was performed to fit eFACE subset scores (static, dynamic, and synkinesis) to disfigurement ratings. A hybrid regression model was then used to weight each of the 15 eFACE variables, using stepwise regression to control for the effect of the other variables. Scoring was performed during an 8-week period from March 16 to May 8, 2015.
MAIN OUTCOME AND MEASURE
Use of the 100-point eFACE variables, together with a 100-point visual analog scale of disfigurement, with 0 representing the most extreme disfigurement possible from a facial nerve disorder and 100 representing no discernible facial disfigurement.
RESULTS
In the 200 patients included in analysis (126 [63.0% female]; mean [SD] age, 46.5 [16.4] years]), predicted disfigurement scores based on eFACE subset scores demonstrated excellent agreement with surgeon-graded disfigurement severity (r2 = 0.79). Variable weighting demonstrated that the 6 key contributors to overall disfigurement were (in order of importance) nasolabial fold depth at rest (normalized coefficient [NC], 0.18; P < .001), oral commissure position at rest (NC, 0.15; P < .001), lower lip asymmetry while pronouncing the long /ē/ (NC, 0.09; P < .001), palpebral fissure width at rest (NC, 0.09; P < .001), nasolabial fold orientation with smiling (NC, 0.08; P = .001), and palpebral fissure width during attempts at full eye closure (NC, 0.06; P = .03).
CONCLUSIONS AND RELEVANCE
A mathematical association between eFACE-measured facial features and overall expert-graded disfigurement in facial paralysis has been established. For those using the eFACE grading scale, predictions of the specific effects of various interventions on expert-rated disfigurement are now possible and may guide therapy.
LEVEL OF EVIDENCE
NA.
Topics: Disability Evaluation; Facial Asymmetry; Facial Paralysis; Female; Humans; Male; Middle Aged; Predictive Value of Tests; Severity of Illness Index
PubMed: 27124886
DOI: 10.1001/jamafacial.2016.0226 -
Dermatologic Therapy Jul 2019Connective tissue disorders (CTDs) are chronic inflammatory conditions that can lead to scarring and disfiguration. Although conventional methods are often of little... (Review)
Review
Connective tissue disorders (CTDs) are chronic inflammatory conditions that can lead to scarring and disfiguration. Although conventional methods are often of little benefit in cutaneous manifestations, the use of cosmetic procedures is still controversial. Concerns have also been raised concerning cosmetic treatments in CTDs, and particularly regarding lasers and fillers, due to photosensitivity and potential reactivation. This article reviews the cosmetic treatment of various CTDs under three headings - lasers, fillers, and botulinum toxin.
Topics: Botulinum Toxins; Connective Tissue Diseases; Cosmetic Techniques; Dermal Fillers; Humans; Laser Therapy
PubMed: 30983128
DOI: 10.1111/dth.12935