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Background  Facial paralysis (FP) is a neuromotor dysfunction that losses voluntary muscles movement in one side of the human face. As the face is the basic means of social interactions and emotional expressions among humans, individuals afflicted can often be introverted and may develop psychological distress, which can be even more severe than the physical disability. This paper addresses the problem of objective facial paralysis evaluation.    Methods  We present a novel approach for objective facial paralysis evaluation and classification, which is crucial for deciding the medical treatment scheme. For FP classification, in particular, we proposed a method based on the ensemble of regression trees to efficiently extract facial salient points and detect iris or sclera boundaries. We also employ 2  n  d   degree polynomial of parabolic function to improve Daugman’s algorithm for detecting occluded iris boundaries, thereby allowing us to efficiently get the area of the iris. The symmetry score of each face is measured by calculating the ratio of both iris area and the distances between the key points in both sides of the face. We build a model by employing hybrid classifier that discriminates healthy from unhealthy subjects and performs FP classification.    Results  Objective analysis was conducted to evaluate the performance of the proposed method. As we explore the effect of data augmentation using publicly available datasets of facial expressions, experiments reveal that the proposed approach demonstrates efficiency.    Conclusions  Extraction of iris and facial salient points on images based on ensemble of regression trees along with our hybrid classifier (classification tree plus regularized logistic regression) provides a more improved way of addressing FP classification problem. It addresses the common limiting factor introduced in the previous works, i.e. having the greater sensitivity to subjects exposed to peculiar facial images, whereby improper identification of initial evolving curve for facial feature segmentation results to inaccurate facial feature extraction. Leveraging ensemble of regression trees provides accurate salient points extraction, which is crucial for revealing the significant difference between the healthy and the palsy side when performing different facial expressions.

paraFaceTest: an ensemble of regression tree-based facial features extraction for efficient facial paralysis classification