PROJECT SUMMARY
Facial transplantation is a relatively new and promising surgical option for people who have
suffered severe facial injury and disfigurement. The precipitating events resulting in facial
transplantation vary but include chemical burn, electrical burn, animal attack, gunshot,
neurofibromatosis, and damage due to oncological treatment and radiotherapy. To date, over 30
facial transplantations have been performed worldwide, seven of them at Brigham and Women's
Hospital in Boston. Although facial mobility appears to be slowly improving in these patients,
speech deficits persist due to persistent lip muscle weakness. Now that technologic and
immunologic feasibility of this surgery have been established, the next steps for improving
clinical science and management is to (1) determine baseline rates of facial motor recovery in a
cohort of patients, (2) test the efficacy of exercise for improving facial motor and speech
outcomes, and (3) improve the accuracy of outcome measures used in clinical assessments, in
research on mechanisms of recovery, and in clinical trials of surgical and behavioral
interventions. The proposed series of studies addresses each of these needs by leveraging
state-of-the-art 3D facial movement tracking technology to quantify recovery post-facial
transplantation and to provide real-time feedback of lip movement treatment targets. Our
established interdisciplinary team, with expertise in speech-language pathology, motor speech,
clinical neurology, and facial transplantation, is well positioned to conduct this research. The
findings will (1) advance understanding of functional recovery following face transplantation, (2)
identify the most useful outcome measures for use in routine clinical assessments of facial
motor function for future clinical trials, and (3) provide preclinical data on the safety, compliance,
and efficacy of a home-based lip exercise program. The findings are also likely to be relevant for
improving the assessment and treatment of a broad range of other facial motor impairments,
both congenital and acquired.