Salerno G M, Bleicher J N, Stromberg B V
Division of Plastic and Reconstructive Surgery, Creighton University School of Medicine, Omaha, NE 68131.
Ann Plast Surg. 1990 Nov;25(5):360-71. doi: 10.1097/00000637-199011000-00004.
The paralytic lagophthalmos following palpebral nerve neurotmesis and consequent peripheral denervation of the orbicularis oculi muscle is often associated with harmful effects on the exposed cornea. This study investigated how daily electrical stimulation affects the blink reflex recovery of this muscle after its reinnervation. Six dogs underwent unilateral facial nerve neurotmesis with immediate epineurial repair of the palpebral nerve. Three dogs were randomly chosen to receive electrical stimulation of the reinnervated orbicularis oculi muscles for 75 days. The remaining 3 dogs were controls (nonstimulated muscles). During the study, the reinnervated orbicularis oculi muscle electrophysiology and blink reflex recovery were investigated. The Student's t test was used for statistical analysis. The results can be summarized as follows: (1) between 30 and 50 days, the minimum mean stimulus intensities evoking complete up-per palpebral closure of the stimulated muscles were significantly lower than those of the nonstimulated muscles (p less than 0.01) and (2) the stimulated muscles recovered complete closure of the interpalpebral fissure (blink reflex) at 49.6 days, significantly earlier (p less than 0.01) than the nonstimulated muscles (72.6 days). It is concluded that daily electrical stimulation of the orbicularis oculi muscles, if started immediately after epineurial repair of the palpebral nerve neurotmesis, promotes a faster blink reflex recovery in the dog model.
睑神经神经断伤及随之而来的眼轮匝肌周围神经去神经支配后出现的麻痹性兔眼症，常对暴露的角膜产生有害影响。本研究调查了每日电刺激对该肌肉再神经支配后眨眼反射恢复的影响。6只犬接受了单侧面神经神经断伤，并立即进行睑神经的神经外膜修复。随机选择3只犬对再神经支配的眼轮匝肌进行75天的电刺激。其余3只犬作为对照（未刺激的肌肉）。在研究过程中，对再神经支配的眼轮匝肌进行电生理检查并观察眨眼反射恢复情况。采用Student's t检验进行统计学分析。结果总结如下：(1)在30至50天之间，引起受刺激肌肉上睑完全闭合所需的最小平均刺激强度显著低于未受刺激的肌肉（p<0.01）；(2)受刺激的肌肉在49.6天恢复睑裂完全闭合（眨眼反射），明显早于未受刺激的肌肉（72.6天，p<0.01）。结论是，在睑神经神经断伤进行神经外膜修复后立即开始每日对眼轮匝肌进行电刺激，可促进犬模型中眨眼反射更快恢复。
