Ledgerwood Levi G, Tinling Steven, Senders Craig, Wong-Foy Annjoe, Prahlad Harsha, Tollefson Travis T
Department of Otolaryngology–Head and Neck Surgery, University of California-Davis Medical Center, Sacramento, CA 95817, USA.
Arch Facial Plast Surg. 2012 Nov;14(6):413-8. doi: 10.1001/archfacial.2012.696.
Current management of permanent facial paralysis centers on nerve grafting and muscle transfer; however, limitations of those procedures call for other options.
To determine the durability and biocompatibility of implanted artificial muscle in a gerbil model and the degree of inflammation and fibrosis at the host tissue-artificial muscle interface.
Electroactive polymer artificial muscle (EPAM) devices engineered in medical-grade silicone were implanted subcutaneously in 13 gerbils. The implanted units were stimulated with 1 kV at 1 Hz, 24 h/d via a function generator. Electrical signal input/output was recorded up to 40 days after implantation. The animals were euthanized between 23 and 65 days after implantation, and the host tissue-implant interface was evaluated histologically.
The animals tolerated implantation of the EPAM devices well, with no perioperative deaths. The muscle devices created motion for a mean of 30.3 days (range, 19-40 days), with a mean of 2.6 × 106 cycles (range, 1.6 × 106 to 3.5 × 106 cycles). Histologic examination of the explanted devices revealed the development of a minimal fibrous capsule surrounding the implants, with no evidence of bacterial infection or inflammatory infiltrate. No evidence of device compromise, corrosion, or silicone breakdown was noted.
Artificial muscle implanted in this short-term animal model was safe and functional in this preliminary study. We believe that EPAM devices will be a safe and viable option for restoration of facial motions in patients with irreversible facial paralysis.
目前永久性面瘫的治疗主要集中在神经移植和肌肉转移;然而,这些手术的局限性需要其他选择。
确定在沙鼠模型中植入的人工肌肉的耐久性和生物相容性,以及宿主组织与人工肌肉界面处的炎症和纤维化程度。
将用医用级硅胶制造的电活性聚合物人工肌肉(EPAM)装置皮下植入13只沙鼠体内。通过函数发生器以1Hz、1kV的频率每天24小时刺激植入的装置。记录植入后长达40天的电信号输入/输出。在植入后23至65天对动物实施安乐死,并对宿主组织与植入物的界面进行组织学评估。
动物对EPAM装置的植入耐受性良好,无围手术期死亡。肌肉装置产生运动的平均时间为30.3天(范围为19 - 40天),平均循环次数为2.6×10⁶次(范围为1.6×10⁶至3.5×10⁶次)。对取出装置的组织学检查显示,植入物周围形成了最小限度的纤维囊,没有细菌感染或炎性浸润的迹象。未发现装置损坏、腐蚀或硅胶分解的证据。
在这项短期动物模型中植入的人工肌肉在这项初步研究中是安全且有功能的。我们认为,EPAM装置将是不可逆面瘫患者面部运动恢复的一种安全可行的选择。