First Evaluation of Zygomaticus Major Muscle Elastic Properties Using a US Elastography Technique

Abstract

Facial expressions are linked to movements of muscles, which can be altered by pathological diseases. Assessment of facial muscle deficits is subjective (palpation) and operator-dependent, and these deficits are currently estimated with clinical scales. Thus, the quantification of facial muscle elastic properties is a key for the clinical adaption and evaluation of treatments for facial paralysis. We herein present a novel application of shear wave elastography (SWE) based on an ultrasound protocol to assess the morphological (thickness and texture) and elastic (Young’s modulus) properties of the zygomaticus major (ZM) muscle. Fifteen healthy volunteers underwent SWE tests, and the ultrasound acquisitions were obtained using a new linear transducer (SLH20-6, spatial resolution: 38 µm) and compared to those obtained using an SL10-2 probe (spatial resolution: 50 µm). The probe position was placed along the muscle fiber orientation. A semi-automatic method was developed to quantify the ZM muscle elasticity, and the repeatability was analyzed at one-week intervals. The mean elasticity for the two probes was about 15 kPa. The SLH20-6 probe yielded a higher mean elasticity (approximately 6 kPa) and less homogeneous echogenicity than the SL10-2 probe. Two distinct groups of texture profiles as a function of the transducer were obtained. This study will provide some guidance for clinical practices and will allow the construction of a reference database that could be used to evaluate treatments and develop numerical models of facial expression.