Development of a new documentation system for facial movements as a basis for the international registry for neuromuscular reconstruction in the face.

None of the paresis scoring systems used satisfies an adequate description of all the details necessary to document the degree of facial paresis before and after any treatment. We developed a new documentation system considering all details of the history of the patient and of the treatment that could have any influence on the functional result. The third part of this "international registry for neuromuscular reconstruction in the face" concerns paralysis assessment, including quantitative measurements of the resting and moving face, besides qualitative parameters. A map of standardized static and dynamic points in the face was designed, and three-dimensional measurements of the movements of these facial points were performed with a VICON system in 16 healthy individuals. On the basis of the results, three real static points and representative dynamic points were selected as well as relations of these points most representative for the different facial movements. For data collection, a simple instrument (Frey's faciometer) was developed. A preliminary report is given on the clinical application of this new instrument.