Posted by Dr Charles Nduka.

The impact to Bethan's skull could have killed her. Then aged 22, she was involved in a terrible car accident which left her with multiple skull fractures and in a coma for 2 weeks. The impact meant that nerves carrying impulses to both sides of her face were severed. When Bethan eventually awoke she was confronted with an immobile face and was unable to blink, close her eyes to sleep, seal her lips when eating or drinking and unable to express any emotion. She was eventually transferred to the Queen Victoria Hospital for facial reanimation as it was not possible to repair the nerves. Over the course of several operations by myself and colleagues, she has made good progress. Whilst she is unable to express the gamut of facial expressions, she has gained tremendous confidence and has been proactive as a charity volunteer and fund-raiser. Sadly, even under ideal conditions, facial nerve repair is fundamentally unpredictable and muscle transplants rarely give completely natural-looking results. 

Imprisoned in a crowded city

For me, one of the most frustrating things about facial reanimation surgery is the difficulty in helping patients with their rehabilitation- particularly in the early recovery phase. Most struggle with looking in a mirror, yet it's extremely hard to develop control over muscles when you cannot observe what you're doing. Consequently, the very time when patients need to actively move their facial muscles and practice social interactions is the time when they least want to be confronted with their reflection or the reaction of others. It's totally understandable, but this sets up a negative cycle of impaired facial function, resulting in social isolation which further reduces the natural rehabilitation that would occur through face to face interaction. Whilst Bethan was fortunate in having a loving family and the support of friends, it's clear that for many, outcomes could be improved through improving social interaction early after treatment. This would provide timely feedback to the individual about their facial expressions and muscle activity..

Bethan following her surgery. Image credit: Matthew Pover, with permission

Bethan following her surgery. Image credit: Matthew Pover, with permission

Facial palsy arising from any cause (Bell's palsy, infections, tumours, or accidents) often causes patients to stop socialising- some may change or lose their jobs due to their appearance.  Studies have demonstrated an increased risk of anxiety and depression which I am sure (through facial feedback) is linked with the impact on social isolation.

We take for granted the ability to smile, drink without dribbling or kiss a loved one. It's only when things go wrong that we appreciate them. I am regularly reminded of the physical, social and psychological impact of losing one's facial expressions. Before we learn to communicate through speech or the written word, we instinctively use facial expressions to communicate our inner feelings. Rapidly and silently we transmit to others our joy, surprise, fear, anger, anxiety, sorrow and pain. Our facial expressions are the closest thing to telepathy that exists.

At Emteq, we have developed a technology that has the potential to help people like Bethan, but also others in widely differing situations. Our team and advisors are a unique collaboration of experts in healthcare, artificial intelligence, sensor technologies, wearable computing, academic research, and software development. Our vision is to develop technologies that enable people to do more, interact more, and feel better. Sign up for updates to learn more.

Why virtual reality

Virtual reality represents a unique opportunity to study human behaviour. There have been a number of studies looking to use VR for rehabilitation or for psychology research. With VR everything is adaptable- what we see, hear, and in the future what we touch, smell and taste.  In our next posts we'll be digging a little deeper into the potential applications of VR in health and research.

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