Study on the method of microelectrodes implantation of artificial facial nerve prosthesis in closed mouth of orbicularis oris muscle in monkeys with facial nerve paralysis / 中华口腔医学杂志

Objective@#To explore the optimal method of microelectrode implantation that can produce efficient mouth closure with microelectrode for orbicularis oris muscle (OOM) in rhesus monkeys with unilateral peripheral facial paralysis (UPFP) in order to provide basis for the research and development of artificial facial nerve prosthesis (AFNP).@*Methods@#Right lateral peripheral facial paralysis model on four healthy rhesus monkeys (two males and two femles, aged 5-6 years, weighed 2.0-3.0 kg) were prepared. AFNP electric stimulation was used to induce closed-mouth reaction of the affected OOM with a one-way rectangular pulse, 50 Hz frequency and 0.2 ms pulse width in vitro. Around the affected lateral OOM, four stimulus electrodes implantation positions were selected at the upper lip (position A), the lower lip (position B), the connection with the corner of the mouth to the ipsilateral tragus (position C), and the horizontal line of the mouth angle (position D). According to the different implantation positions of three stimulation electrodes on the stimulation side of AFNP and the results of our previous study, six groups of microelectrode implantation methods were designed. In Group A, two microelectrodes were implanted at position A and one microelectrode was implanted at position B; in Group B, one microelectrode was implanted at position A, B and C respectively; in Group C, one microelectrode was implanted at position A and two microelectrodes were implanted at position B; in Group D, one microelectrode was implanted at position A, B and D respectively; in Group E, one microelectrode was implanted at position A, C and D respectively; in Group F, one microelectrode was implanted at position B, C and D respectively. The minimum stimulating current (threshold current) required for effective mouth closure were recorded. The threshold and peak current values were compared using one-way ANOVA and LSD-t multiple comparisons.@*Results@#The microelectrodes of the AFNP stimulating side in Group E and F failed to induce a smooth mouth closure. The microelectrodes in A, B, C and D group induced smooth mouth closure. The threshold current value of OOM contraction on affected side in the Group A, B, C, and D were (1.35±0.05), (1.02±0.04), (1.40±0.04) and (1.10±0.02) mA, respectively (F=295.302, P<0.001), with the lowest value in Group B and there was significant difference between the current value in Group B and those in the other groups (all P<0.05). The peak current value of OOM contraction on affected side in the four groups were (3.95±0.02), (2.95±0.03), (3.99±0.05) and (3.51±0.01) mA, respectively (F=1 014.985, P<0.001). Group B showed the best lip-closure morphology observed with naked eyes.@*Conclusions@#When three output microelectrode of the AFNP stimulated side are separately imbedded into the upper lip, the lower lip and the connection with the corner of the mouth to the ipsilateral tragus, AFNP can sufficiently induce closed-mouth reaction. These positions are suitable as priority options microelectrodes implantation positions for the microelectrodes of the AFNP stimulated side.

Positions of the implanted stimulating electrodes for artificial facial nerve for inducing contraction of the orbicularis oris muscle in rabbit with peripheral facial paralysis / 中华耳鼻咽喉头颈外科杂志

Objective@#To explore the optimal positions of the implanted stimulating eletrodes for artificial facial nerve (AFN) for inducing contraction of the orbicularis oris muscle (OOM) in rabbit with peripheral facial paralysis.@*Methods@#According to the four microelectrodes of the AFN stimulating side, four modes of the implanted positions were divided. In line with different modes, the electrodes were implanted into the affected OOM of the rabbits with unilateral peripheral facial paralysis. AFN output electric stimulation to induce contraction of the affected OOM with uniform stimulating frequency and pulse length in vitro. Then compared the stimulus threshold amplitude and the peak amplitude separately among different modes by SAS 9.3 version statistical software.@*Results@#The differences of the stimulus threshold amplitude and the peak amplitude had no statistically significant separately between the first mode and the second mode (P>0.05), but there were statistically significant differences between the third mode and the fourth mode (P<0.05). Both kinds of the amplitudes were approximated between the first mode and the second mode respectively, and higher than those in the third mode or the fourth mode. Furthermore, both kinds of the amplitudes in the fourth mode were higher than those in the third mode.@*Conclusions@#The microelectrodes of the AFN stimulating lateral are implanted into the upper lip with a public microelectrode and an output microelectrode, into the lower lip with an output microelectrode, and into the way, which is located to the angle 40° to 45° about the line joining between the midpoint of the ipsilateral auricle root and the corner of the mouth with an output microelectrode. This is the third positional mode which requires lowest effective stimulus current intensity. Thus the mode is suitable as the optimal placement programme.

Cause and treatment of unilateral vocal cord paralysis / 临床耳鼻咽喉头颈外科杂志

Unilateral vocal cord paralysis(UVCP) is defined as affected side vocal cord emerges immobility or motion weakening and abnormal tension due to unilateral intrinsic laryngeal muscles suffering from disorder about motor nerve. The patients usually present with hoarse voice, disability of high pitch, cough, aspiration, or a combination of these symptoms. There are increasing therapeutics researches and case analyses regarding UVCP in recent years. Thus this review summarized the progression about its causes and treatment methods.

Low-temperature radiofrequency technology treatment of spontaneous tonsillar hemorrhage: a case report / 临床耳鼻咽喉头颈外科杂志

Patient, 30-year-old, male,was admitted to our hospital because of discontinuously spit fresh blood without any inducing factors for three days. In the course, the patient suffered mild dry sensation of pharyngeal, poor spirit condition, fatigue, poor sleep, poor appetite and was with black stool 2 times. Physical examination: T36. 6°C, R 21/min, P98/min, BP135/90 mmHg (1 mmHg = 0.133 kPa). Bilateral tonsils were III hypertrophy and with scar shape surfaces. The left tonsil's surface had longitudinal small blood vessels markedly dilated. His oropharynx, laryngopharynx and laryngeal did not be find any obvious bleeding sites. Laboratory findings: WBC 13.82 x 10(9)/L, N 0.8084, L 0.1632, Hb 81.00 g/L, HCT 25.20; PT 9.60 s, APTT 25.50 s, TT 15.80 s, FIB 1.900 g/L. After 3 hours of admission,the patient spit out fresh blood again,checked the body to see:the left peri-tonsil with fresh blood and found a slowly bleeding site at the 1/3 junction of the middle lower part of left tonsil's rear surface, the size was about 0.5 cm x 0.6 cm. We finally diagnosed spontaneous tonsillar hemorrhage and successfully managed with low-temperature radiofrequency technology.