The clinical effects on the salivation of children with cerebral palsy of oral-facial muscle training based on action observation and a virtual environment / 中华物理医学与康复杂志

Objective:To observe the effect of oral-facial muscle training applying virtual reality technology (VR) and of action observation therapy on the salivation of children with cerebral palsy (CP).Methods:Sixty CP children with uncontrolled salivation were randomly divided into a control group and an observation group, each of 30. In addition to conventional rehabilitation treatment, the control group received routine tongue muscle training, buccal lip muscle training, ice stimulation, and Masako swallowing training. The observation group received oral-facial muscle training based on action observation therapy in a virtual environment. Both groups were trained 30min per day, 5 times a week for 3 weeks. Before and after the treatment, drooling (DDSS) and swallowing function scores were evaluated. Integrated surface electromyography (iEMG) of the buccinator and orbicularis oris muscles was also performed.Results:After treatment, a significant decrease was observed in the average DDSS and the swallowing function scores of both the control and observation groups, along with a significant increase in the average root mean square values of the buccinator and orbicularis oris iEMGs of both groups. However, the average DDSS score of the observation group was significantly lower than that of the control group, while the average iEMG readings were significantly better.Conclusion:VR-based action observation oral-facial muscle training is a more effective supplement to conventional rehabilitation treatment than conventional oral-facial muscle training in improving the salivation of children with CP.

Anatomical repair of a bilateral Tessier No. 3 cleft by midfacial advancement / 대한악안면성형재건외과학회지

BACKGROUND: Bilateral Tessier number 3 clefts are extremely rare, and their surgical treatments have not been well established. CASE PRESENTATION: The authors describe the case of a patient with a right Tessier number 3, 11 facial cleft with microphthalmia, a left Tessier number 3 facial cleft with anophthalmia, and cleft palate. We repaired simultaneously the bilateral soft tissue clefts by premaxillary repositioning, cleft lip repair, facial cleft repair by nasal lengthening, midfacial advancement, and an upper eyelid transposition flap with repositioning both the medial canthi. Postoperatively, the patient showed an esthetically acceptable face without unnatural scars. CONCLUSIONS: We achieved good results functionally and esthetically by midfacial advancement with facial muscle reposition instead of traditional interdigitating Z-plasties. The surgical modality of our anatomical repair and 3 months follow-up results are presented.

Ten Years of Results of Modified Frontalis Muscle Transfer for the Correction of Blepharoptosis

BACKGROUND: Conventional frontalis transfer may cause a range of complications. In order to overcome complications, we made modifications to the surgical technique, and compared the outcomes of patients who underwent conventional frontalis transfer with those of patients who underwent modified frontalis transfer. METHODS: We conducted a retrospective study of 48 patients (78 eyes) who underwent conventional frontalis transfer between 1991 and 2003 (group A) and 67 patients (107 eyes) who underwent modified frontalis transfer between 2004 and 2014 (group B). The frontalis transfer procedures were modified conform to the following principles. The tip of the frontalis muscle flap included soft tissue that was as thick as possible and the soft tissue on the tarsal plate was removed to the greatest extent possible. A double fold was created in cases of unilateral ptosis. In order to evaluate the objective effects of modification, preoperative and postoperative values of the marginal distance reflex 1 (MRD1), the corneal exposure area, and the decrease in eyebrow height were compared between the two groups. RESULTS: In group A, patients showed an improvement of 1.19 mm in the MRD1, a 6.31% improvement in the corneal exposure area, and a 7.82 mm decrease in eyebrow height. In group B, patients showed an improvement of 2.17 mm in the MRD1, an 8.39% improvement in the corneal exposure area, and an 11.54 mm decrease in eyebrow height. The improvements in group B were significantly greater than those in group A. CONCLUSIONS: Modified frontalis transfer showed better results than the conventional procedure and provided satisfactory outcomes.

Individualized Considerations Regarding Sub-Superficial Musculoaponeurotic System Facelift Techniques

Based on a thorough understanding of facial structure around the superficial musculoaponeurotic system (SMAS), some types of sub-SMAS techniques have emerged to allow more harmonious rejuvenation procedures in the lower face and midface. These techniques are the Hamra composite facelift, the Stuzin extended SMAS technique, the Barton high SMAS technique, and the Ramirez subperiosteal facelift, each of which involves a specific dissection plane and is informed by distinct rationales with reasonable support. Each patient presents a unique facial structure and undergoes an individual rate of aging. The facial structures of East Asian faces, in particular, differ from those of Western faces. While emphasizing that the theory of structural mid-cheek anatomy is an essential part of facial rejuvenation, we would like to discuss the advantages and disadvantages of various sub-SMAS facelift techniques and to propose the most suitable techniques for a variety of individual faces.

Effect of Local Insulin Injection on Crushed Injury of Facial Nerve in Rats / 中国康复理论与实践

Objective To investigate the effect of local insulin injection on neurological function after crushed injury of facial nerve in rats. Methods Facial nerve was crushing injured in 30 Sprague-Dawley rats, from which 20 selected rats were divided into treatment group (n=10) and control group (n=10). The treatment group was injected with insulin 250 ng/kg at innervated muscle, and the control group was injected with normal saline. They were assessed with neurologic deficit score everyday within 7 days after injection, and the regeneration of nerve fiber was observed with retrograde fluorogold labeling. Results Compared with that in the control group, the neurological deficit score was improved more 5~7 days after injection in the treatment group, and the count of fluorogold labeling cells increased more in the treatment group. Conclusion Local injection of insulin can promote the recovery of neurological function after crushed injury of facial nerve.

Effect of Local Insulin Injection on Crushed Injury of Facial Nerve in Rats / 中国康复理论与实践

@#Objective To investigate the effect of local insulin injection on neurological function after crushed injury of facial nerve in rats. Methods Facial nerve was crushing injured in 30 Sprague-Dawley rats, from which 20 selected rats were divided into treatment group (n=10) and control group (n=10). The treatment group was injected with insulin 250 ng/kg at innervated muscle, and the control group was injected with normal saline. They were assessed with neurologic deficit score everyday within 7 days after injection, and the regeneration of nerve fiber was observed with retrograde fluorogold labeling. Results Compared with that in the control group, the neurological deficit score was improved more 5~7 days after injection in the treatment group, and the count of fluorogold labeling cells increased more in the treatment group. Conclusion Local injection of insulin can promote the recovery of neurological function after crushed injury of facial nerve.

Efficacy of Facial Muscle Exercise on Peripheral Facial Paralysis: 45 Cases Report / 中国康复理论与实践

@#Objective To investigate the efficacy of facial muscle exercise on peripheral facial paralysis. Methods 45 patients with peripheral facial paralysis were treated with acupuncture, physical therapy and facial muscle exercise. Results The effective rate was 100% and 44.4% were cured after 2 courses of treatment. Conclusion The facial muscle exercise is effective on peripheral facial paralysis.

Topographic Anatomy of the Facial Nerve Innervating the Muscles in Glabellar Area

The aim of this study is to identify the branches of the facial nerve to the corrugator supercilii muscle(CSM), upper orbicularis oculi muscle(OOM) and procerus muscle(PM), and to elucidate the relation between the course of facial nerve and the superficial landmark of face. Furthermore, this study is also aimed to present anatomical information which is attributed to the treatment of the glabellar frowning wrinkles using selective neurectomy. Cadaver dissection was done on 19 hemifaces to investigate the distribution of the temporal branch of the facial nerve and its entering into the CSM. Twenty hemifaces of cadavers were dissected to investigate the pattern of the temporal branch of the facial nerve to the upper OOM, and the course of facial nerve into the OOM at three different sagittal/vertical planes through the lateral canthus, midpalpebral fissure, and medial canthus, respectively. Twenty-three hemifaces of cadavers were dissected for the investigation of nerve innervation to PM, and identification of the main trunk of the facial nerve and the buccal branches to the nasal bridge. A crossing point between buccal branch and the intercanthal line, and the entering point of the buccal branch into the PM were measured. 1. The temporal branch of the facial nerve contained 2 to 4 smaller branches on the zygomatic arch, and they were furtherly divided into 4 to 7 thin rami at the position 2.8 to 25 mm above the point 10mm lateral to the supraorbital notch. A plexus mainly from the inferior ramus, partially from the middle ramus entered into the CSM in the supraorbital area. 2. The ramifying point of the temporal branch was continued to the circular hazardous zone with a 10mm diameter, and its center was 7.5cm away from the lateral canthus at angle of minus 15 degrees. The highest level of the those rami that entered OOM on the X-axis and Y-axis from lateral canthus was +2.51+/-0.23cm, +2.70+/-0.35cm, and the lowest was +2.68+/-0.32cm, 0cm, respectively. The uppermost ramus on the Y-axis from lateral canthus, midpalpebral fissure, and medial canthus was +3.47 +/-0.27cm, +3.49+/-0.45cm, and +2.97+/-0.35cm, and the lowest ramus was +1.62+/-0.12cm, +1.82+/-0.17cm, and +1.63+/-0.22 cm, respectively. 3.The PM was innervated by the buccal branch of the facial nerve, which coursed infraorbitally. The buccal branch crossed the intercanthal line(nasion to the medial canthus) at approximately lateral one third. The nerve entrance was within a circle with a diameter of 5mm and the location of its center was 9.1mm lateral and 10.4mm superior from nasion. The present study shows the identification of nerve innervation to CSM, OOM and PM, and the relation between the course of facial nerve and the superficial landmark of face. We elucidated especially the course and entering point of buccal branch of the facial nerve to procerus muscle for the first time. We confirm that selective cutting of buccal branch of the facial nerve is essential to the treatment of the glabellar frowning lines. Furthermore, the anatomic knowledge from this study might be contributive to improve the efficacy of selective neurectomy and minimize the injury of facial nerve during surgical procedure of the face.

Development of Character Input System using Facial Muscle Signals / 대한의료정보학회지

A person does communication between each other using language. But, In the case of disabled person, he/she could not transfer own idea to others by using the writing or gesture. We embodied communication system using the facial muscle signals so that disabled person can do communication. After feature extraction from the facial muscle signals, it is converted to the control signal, and then disabled person could transfer his/her intention by select characters.

Electromyography activities of the facial and neck muscles in children with high-angle / 实用口腔医学杂志

Objective:To investigate the electromyography activities of the facial and neck muscles during mandibular movement in children with high-angle.Methods:A computer-integrated BioEMG Ⅱ diagnostic system was used to synchronously record the electromyography activities of temporal anterior(TA), masseter muscle(MM), sternocleidomastoid(SCM) and digastric anterior(DA) muscles during mandibular movement in 14 children with high-angle and 16 children with normal-angle.Results:Muscular activity of TA, DA and SCM in children with high-angle was significantly weaker than that in those with normal-angle in the rest position(P