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Comment & Response
Nov/Dec 2014

Application of the Blink Assessment in Facial Transplantation

Author Affiliations
  • 1Division of Plastic, Reconstructive, and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, Maryland
  • 2Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins Hospital, Baltimore, Maryland
  • 3Department of Plastic Surgery, Institute of Reconstructive Plastic Surgery, New York University Langone Medical Center, New York, New York
JAMA Facial Plast Surg. 2014;16(6):457. doi:10.1001/jamafacial.2014.631

To the Editor The importance of the blink mechanism, both volitional and reflexive, is paramount to ocular protection and health. We commend Frigerio et al1 in pursuing a novel technological application to accurately detect blink.1 In their article, Frigerio et al1 explain that the purpose of their “proof of concept” model is to validate the infrared LED system to eventually improve the treatment of facial paralysis. Our experience in complex facial reconstruction2 and vascularized composite allotransplantation, namely facial transplantation,3 has elucidated the importance of blink assessment, preservation, and restoration. Objective and novel blink assessment tools may translate not only to patients with facial paralysis but can be used in evaluating patients who undergo autologous reconstruction or facial allotransplantation. Although there is promise to the system proposed by Frigerio et al1 in computing frequency or quantifying blink, it falls short in several aspects of determining the quality and clinical relevance of the blink mechanism.

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