To date, treatment of peripheral facial paralysis has focused on preservation of facial nerve integrity. However, with seriously damaged facial nerve cases, it is difficult to recover anatomical and functional integri...To date, treatment of peripheral facial paralysis has focused on preservation of facial nerve integrity. However, with seriously damaged facial nerve cases, it is difficult to recover anatomical and functional integrity using present therapies. Therefore, the present study utilized artificial facial nerve reflex to obtain orbicularis oculi muscle （OOM） electromyography signals on the uninjured side through the use of implanted recording electrodes. The implanted electrical chips analyzed facial muscle motion on the uninjured side and triggered an electrical stimulator to emit current pulses, which resulted in stimulation of injured OOM contraction and maintained bilateral symmetry and consistency. Following signal recognition, extraction, and computer analysis, electromyography signals in the uninjured OOM resulted in complete eyelid closure, which was consistent with the voltage threshold for eye closure. These findings suggested that artificial facial nerve reflex through the use of implanted microelectronics in unilateral peripheral facial paralysis could restore eyelid closure following orbicularis oculi muscle denervation.展开更多
We had a case of 75-year old man with a history of progressive hearing loss on both side who implanted with a Nucleus 24 Contour Advance in the right ear. After 4 years from implantation, the patient started to compla...We had a case of 75-year old man with a history of progressive hearing loss on both side who implanted with a Nucleus 24 Contour Advance in the right ear. After 4 years from implantation, the patient started to complaint of right facial twitching when his cochlear implant was active. Despite undergoing numerous alterations in his implant programming, facial nerve stimulation (FNS) persisted. After increasing the pulse width and changing the stimulation mode, there was no facial nerve stimulation. However there was a deterioration in hearing and speech understanding. CT of the temporal bone showed good position of the implant electrodes und cochleomeatal scintigraphy (CMS) showed a highly positive activity with suspicion of otosclerosis, although the medical history was negative for otosclerosis. The FNS was managed with cochlea reimplantation and advanced programming techniques. FNS in cochlear implant patients may be managed through reimplantation and advanced programming techniques.展开更多
Aim:The frontal branch of the facial nerve is particularly vulnerable to traumatic injury or during surgery.While the larger branches of the facial nerve,such as the buccal branch,are more easily identifiable and amen...Aim:The frontal branch of the facial nerve is particularly vulnerable to traumatic injury or during surgery.While the larger branches of the facial nerve,such as the buccal branch,are more easily identifiable and amenable to repair,the repair of the frontal branch is not common due to its complex branching pattern and smaller size.The description of the surgical approach to repair the frontal branch of the facial nerve is limited in the literature.In this study,we aim to explore the outcomes of patients who underwent frontal branch facial nerve repair in our centre.Method:In a retrospective case review at a single,tertiary Plastic Surgery centre,we performed frontal branch repair for eight patients(n=8)who sustained complete or partial division of the frontal branch of the facial nerves.These patients were followed up postoperatively and assessed with the Sunnybrook Facial Grading System.Results:Using super microsurgical techniques,primary nerve coaptations,fascicular nerve flaps,and direct neurotisations were performed.All eight patients(100%)demonstrated improvements in terms of resting brow symmetry.There was a significant improvement in brow and frontalis function following surgical repair of the frontal branch,with 87.5%(seven patients)demonstrating improvement in forehead movement.Conclusion:In this case series,we demonstrated that the repair of the frontal branch of the facial nerve is relevant,with reasonably good functional outcomes.Repair of the frontal branch of the facial nerve should ideally be done as early as possible following the injury.Nevertheless,delayed repair may still be beneficial within 18 months after the injury.展开更多
Implantable cervical vagus nerve stimulation(i VNS) is a representative and promising neuromodulation.However,the invasive nature restricts its application.Traditional auricular acupuncture treatment has a long histor...Implantable cervical vagus nerve stimulation(i VNS) is a representative and promising neuromodulation.However,the invasive nature restricts its application.Traditional auricular acupuncture treatment has a long history.The auricular branch of the vagus nerve(ABVN) is a branch on the surface of the ear.Some studies demonstrates that transcutaneous auricular vagus nerve stimulation(ta VNS) would achieve similar effects as i VNS.Ta VNS and i VNS share a common anatomical basis and acting mechanism.In this article,we made a comparison between i VNS and ta VNS in indications and efficacy.The recent studies have revealed similar clinical efficacy of ta VNS,ta VNS would expand the indication of i VNS.Highquality clinical evidences are needed before ta VNS become be an alternative of i VNS.展开更多
基金the National Natural Science Foundation of China,No.60876082Shanghai Committee of Science and Technology,No.0852nm06600Shanghai Municipal Education Committee Shanghai "Phosphor" Science Foundation,China,No.08SG13
文摘To date, treatment of peripheral facial paralysis has focused on preservation of facial nerve integrity. However, with seriously damaged facial nerve cases, it is difficult to recover anatomical and functional integrity using present therapies. Therefore, the present study utilized artificial facial nerve reflex to obtain orbicularis oculi muscle （OOM） electromyography signals on the uninjured side through the use of implanted recording electrodes. The implanted electrical chips analyzed facial muscle motion on the uninjured side and triggered an electrical stimulator to emit current pulses, which resulted in stimulation of injured OOM contraction and maintained bilateral symmetry and consistency. Following signal recognition, extraction, and computer analysis, electromyography signals in the uninjured OOM resulted in complete eyelid closure, which was consistent with the voltage threshold for eye closure. These findings suggested that artificial facial nerve reflex through the use of implanted microelectronics in unilateral peripheral facial paralysis could restore eyelid closure following orbicularis oculi muscle denervation.
文摘We had a case of 75-year old man with a history of progressive hearing loss on both side who implanted with a Nucleus 24 Contour Advance in the right ear. After 4 years from implantation, the patient started to complaint of right facial twitching when his cochlear implant was active. Despite undergoing numerous alterations in his implant programming, facial nerve stimulation (FNS) persisted. After increasing the pulse width and changing the stimulation mode, there was no facial nerve stimulation. However there was a deterioration in hearing and speech understanding. CT of the temporal bone showed good position of the implant electrodes und cochleomeatal scintigraphy (CMS) showed a highly positive activity with suspicion of otosclerosis, although the medical history was negative for otosclerosis. The FNS was managed with cochlea reimplantation and advanced programming techniques. FNS in cochlear implant patients may be managed through reimplantation and advanced programming techniques.
文摘Aim:The frontal branch of the facial nerve is particularly vulnerable to traumatic injury or during surgery.While the larger branches of the facial nerve,such as the buccal branch,are more easily identifiable and amenable to repair,the repair of the frontal branch is not common due to its complex branching pattern and smaller size.The description of the surgical approach to repair the frontal branch of the facial nerve is limited in the literature.In this study,we aim to explore the outcomes of patients who underwent frontal branch facial nerve repair in our centre.Method:In a retrospective case review at a single,tertiary Plastic Surgery centre,we performed frontal branch repair for eight patients(n=8)who sustained complete or partial division of the frontal branch of the facial nerves.These patients were followed up postoperatively and assessed with the Sunnybrook Facial Grading System.Results:Using super microsurgical techniques,primary nerve coaptations,fascicular nerve flaps,and direct neurotisations were performed.All eight patients(100%)demonstrated improvements in terms of resting brow symmetry.There was a significant improvement in brow and frontalis function following surgical repair of the frontal branch,with 87.5%(seven patients)demonstrating improvement in forehead movement.Conclusion:In this case series,we demonstrated that the repair of the frontal branch of the facial nerve is relevant,with reasonably good functional outcomes.Repair of the frontal branch of the facial nerve should ideally be done as early as possible following the injury.Nevertheless,delayed repair may still be beneficial within 18 months after the injury.
基金Supported by the China Academy of Chinese Medical Sciences Innovation Fund:Brain Effects and Multimodal Imaging Mechanism of Transcutaneous Auricular Vagus Nerve Stimulation in Patients with Disorder of Consciousness(CI2021A03305)the National Key Research and Development Program:Optimization and Effect Mechanism of Transcutaneous Electrical Cranial-auricular Acupoint Stimulation(TECAS) on Depression(No.2018YFC1705800)。
文摘Implantable cervical vagus nerve stimulation(i VNS) is a representative and promising neuromodulation.However,the invasive nature restricts its application.Traditional auricular acupuncture treatment has a long history.The auricular branch of the vagus nerve(ABVN) is a branch on the surface of the ear.Some studies demonstrates that transcutaneous auricular vagus nerve stimulation(ta VNS) would achieve similar effects as i VNS.Ta VNS and i VNS share a common anatomical basis and acting mechanism.In this article,we made a comparison between i VNS and ta VNS in indications and efficacy.The recent studies have revealed similar clinical efficacy of ta VNS,ta VNS would expand the indication of i VNS.Highquality clinical evidences are needed before ta VNS become be an alternative of i VNS.
