Dental News - Facial transplant surgery improves speech in patient with severe facial trauma, study finds

Dental Tribune International

Mon. 8. April 2019

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NEW YORK, U.S.: Facial transplantation is one of the most extensive facial reconstructive surgeries available. The procedure involves the partial or total replacement of nerves, muscles and skeletal structures of the face, head and neck using donor tissue. A new case study by New York University’s Steinhardt School of Culture, Education, and Human Development has found that facial transplant surgery in a patient who had experienced severe facial trauma improved speech production.

“Our findings provide a window into the complex recovery process following major facial reconstruction and serve as an important foundation from which we can begin to understand how facial transplant can improve speech production preoperatively to postoperatively,” said Dr. Maria I. Grigos, lead author of the study and associate professor at the university. “Among the many remarkable patterns observed, we found that the patient displayed more flexible control of facial movement as he adapted to the transplanted structures.”

Using optical tracking, a form of motion tracking technology, Grigos and her team were able to examine firsthand how the facial transplant procedure altered movement of the face and contributed to improved speech production. The researchers compared data from the case study patient—a male victim who had suffered third- and fourth-degree burns and major soft-tissue loss in a fire—against data on four healthy adult men (controls).

The patient’s speech production and facial movements were examined once before the procedure and four times in the 13 months after the procedure. Movements of the patient’s lips and jaws, as well as the intelligibility of his speech, were compared pre- to post-transplantation and then tracked across the recovery period.

The study found that his speech intelligibility varied across the study period and was restored to control status by seven months post-transplant. Jaw displacement and lip aperture in the vertical plane significantly increased over time for nonspeech and speech tasks. Changes in horizontal lip movements over time were minimal. Jaw and lip movement variability fluctuated over time and was greater than that of the controls by 13 months post-transplant.

“The remarkable changes that we captured in this patient reflect the multiple processes involved in the reintegration of neuromuscular control and in the learning of new strategies over the recovery period. Such adaptability is a positive indicator that treatment to improve speech production can be effective post-facial transplant surgery,” continued Grigos.

The study, titled “Changes in articulatory control pre– and post–facial transplant: A case report,” was published in the February 2019 issue of the Journal of Speech, Language, and Hearing Research.

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