Broniatowski M, Grundfest-Broniatowski S, Davies C R, Jacobs G B, Tucker H M, Nosé Y
Department of Otolaryngology-Head and Neck Surgery, Case Western Reserve University, Cleveland, OH.
Otolaryngol Head Neck Surg. 1991 Nov;105(5):727-33. doi: 10.1177/019459989110500516.
We have recently demonstrated the feasibility of artificial agonist/antagonist coupling between intact facial and reinnervated strap muscles in the rabbit. The present study broadens this principle to involve bi-level cross-facial innervation. After severing the facial innervation unilaterally in four dogs, a nerve pedicle from a cervical motor nerve was implanted into the orbicularis oris and from the deep temporal nerve into the orbicularis oculi. After neurotization (5.6 months), the pedicles were electrically stimulated to verify muscular response. Graded contraction on the intact side was induced by stimulating the ipsilateral facial nerve with currents of various pulse widths. The resulting compression of a strain gauge on the intact face triggered a two-channel, opto-isolated, pulse width-modulated stimulator to produce agonistic graded contraction at one level of the reinnervated side (e.g., oral) and reciprocal relaxation in its reinnervated counterpart (e.g., ocular). The sophistication of the present model--as compared to the original pilot study--brings us one step closer to dynamic human facial rehabilitation.
我们最近已证明在兔体内完整面部肌肉与重新神经支配的带状肌之间进行人工激动剂/拮抗剂耦合的可行性。本研究拓展了这一原理，涉及双平面跨面部神经支配。在四只狗单侧切断面部神经支配后，将来自颈运动神经的神经蒂植入口轮匝肌，并将颞深神经的神经蒂植入眼轮匝肌。在神经再生（5.6个月）后，对神经蒂进行电刺激以验证肌肉反应。通过用不同脉宽的电流刺激同侧面神经，在完整侧诱导出分级收缩。完整面部上应变计产生的压缩触发一个双通道、光隔离、脉宽调制刺激器，在重新神经支配侧的一个水平（如口腔）产生激动性分级收缩，并在其对应的重新神经支配部位（如眼部）产生相反的松弛。与最初的初步研究相比，本模型的复杂性使我们在动态人类面部康复方面又迈进了一步。
