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Traditional grading scales such as House-Brackmann (HB), Sunnybrook, and Fisch are subjective and prone to inter-rater variability. Emotrics, a computer vision\u2013based tool, offers objective facial analysis, but its role in neurosurgical populations remains underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients undergoing VS surgery were prospectively enrolled in this study. Standardized frontal facial photographs were taken preoperatively, at discharge, and at three-month follow-up. Emotrics quantified facial symmetry and movement across static, dynamic, and synkinesis domains. Composite scores were generated and compared with clinical grading scales and patient characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-six patients (mean age 51.2\u2009\u00b1\u200912.3\u00a0years) were included. Emotrics detected significant improvement in dynamic function (mean score: 0.41 at discharge vs. 0.56 at 3\u00a0months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and synkinesis (0.62 to 0.51,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05); static symmetry remained stable. Strongest correlations with clinical grading were found at discharge and 3\u00a0months. Discharge Emotrics total scores correlated significantly with HB (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u20130.883,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), Sunnybrook (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.892,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and Fisch (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.883,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). At 3\u00a0months, dynamic scores remained strongly associated with HB (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u20130.799), Sunnybrook and Fisch (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.790;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Worse Emotrics outcomes were linked to older age (62.1 vs. 48.6\u00a0years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04) and larger tumor volume (8.2 vs. 4.5 cm\n                      <jats:sup>3<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Emotrics offers objective assessment of facial nerve function, correlates well with clinical scales, and enhances evaluation of dynamic facial recovery. Its integration may refine postoperative monitoring and guide rehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00701-026-06933-0","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T13:16:10Z","timestamp":1780578970000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantitative facial analysis using emotrics in patients undergoing vestibular schwannoma surgery"],"prefix":"10.1007","volume":"168","author":[{"given":"Ad\u00e9la","family":"Buben\u00edkov\u00e1","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zden\u011bk","family":"F\u00edk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Tesa\u0159ov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenka","family":"Peterkov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladim\u00edr","family":"Kouck\u00fd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Laz\u00e1k","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Kabo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Gorchakov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Betka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Zv\u011b\u0159ina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ond\u0159ej","family":"Brad\u00e1\u010d","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ale\u0161","family":"Vlas\u00e1k","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"issue":"3","key":"6933_CR1","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/S0194-5998(95)70101-X","volume":"113","author":"American Academy of Otolaryngology-Head and Neck Surgery Foundation, INC","year":"1995","unstructured":"American Academy of Otolaryngology-Head and Neck Surgery Foundation, INC (1995) Committee on Hearing and Equilibrium guidelines for the evaluation of hearing preservation in acoustic neuroma (vestibular schwannoma). 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No additional interventions were performed for research purposes. All data were anonymized prior to analysis to ensure patient confidentiality.","order":1,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All patients included in this study were evaluated and treated as part of routine clinical care with standard informed consent politics involving surgical intervention.","order":2,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"In accordance with local regulations and institutional guidelines, formal ethical approval and written informed consent were not required for this study.","order":3,"name":"Ethics","label":"Human ethics and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","label":"Competing interest","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"181"}}