Salerno G M, Bleicher J N, McBride D M
Creighton University School of Medicine, Department of Surgery, Omaha, NE 68131.
J Invest Surg. 1991;4(4):445-56. doi: 10.3109/08941939109141175.
A canine model of facial nerve paralysis was studied to apply controlled electrical current to the peripherally denervated orbicularis oculi muscle, in the attempt to effectively restore the absent function of this denervated muscle. After unilateral facial nerve neurotmesis was performed in eight dogs, the denervated orbicularis oculi muscles of four dogs were electrically stimulated for 75 postoperative days (40 min/day). Denervated and normal orbicularis oculi muscles were electrophysiologically studied and compared with the Student t test. During the study period, minimum closure of denervated treated orbicularis oculi muscles was evoked with average stimulus strength (80-ms duration) of 1.61 +/- 0.22 log mA x ms, not significantly different from that of denervated nontreated or normal orbicularis oculi muscles. From days 10 through 30 only, maximum closure of denervated treated orbicularis oculi muscles was achieved with mean pulse strength (80-ms duration) of 2.37 +/- 0.09 log mA x ms, significantly lower (P less than .01) than that evoking the same type of contraction from denervated nontreated muscles (80-ms duration, mean 2.83 +/- 0.10 log mA x ms). In addition, denervated treated muscle pulse strength eliciting maximum contraction was not significantly different from that of normal orbicularis oculi muscles during the same period. This finding was not observed, however, from day 40 through the end of the study. This investigation demonstrates (1) the transient reversal of denervation changes of paralyzed orbicularis oculi muscle by daily electrical stimulation, and (2) the feasibility of restoring orbicularis oculi muscle function by controlled electrical current.
研究了一种犬面神经麻痹模型，对周围神经去支配的眼轮匝肌施加可控电流，试图有效恢复该去神经肌肉缺失的功能。在八只犬中进行单侧面神经切断术后，对四只犬去神经支配的眼轮匝肌进行术后75天的电刺激（每天40分钟）。对去神经支配和正常的眼轮匝肌进行电生理研究，并采用学生t检验进行比较。在研究期间，平均刺激强度（持续时间80毫秒）为1.61±0.22 log mA×ms时，可诱发去神经支配且接受治疗的眼轮匝肌最小程度的闭合，这与未接受治疗的去神经支配或正常眼轮匝肌无显著差异。仅在第10天至第30天期间，平均脉冲强度（持续时间80毫秒）为2.37±0.09 log mA×ms时，可实现去神经支配且接受治疗的眼轮匝肌最大程度的闭合，显著低于（P＜0.01）从未接受治疗的去神经支配肌肉诱发相同类型收缩时的强度（持续时间80毫秒，平均2.83±0.10 log mA×ms）。此外，在同一时期，诱发最大收缩的去神经支配且接受治疗的肌肉脉冲强度与正常眼轮匝肌无显著差异。然而，从第40天到研究结束未观察到这一现象。本研究表明：（1）每日电刺激可使麻痹的眼轮匝肌去神经变化短暂逆转；（2）通过可控电流恢复眼轮匝肌功能具有可行性。
