Surgical and Rehabilitative Management of Facial Nerve Injury

项目摘要 我们研究的长期目标是研究恢复和优化面部的机制。 面部麻痹的情况下的运动。拟议研究的具体目标是开发 并研究功能性电刺激（FES）范式的长期可行性， 单侧面神经麻痹（UFP）啮齿动物模型中的动态对称面部运动。我们将 利用导电聚合物电极阵列检测正常啮齿类动物面肌肌电活动 在一侧的脸，和神经袖电极，以唤起对侧相应的 肌肉活动我们将通过植入式信号采集器耦合两个系统， 生成平台，并预期数字信号处理可以应用于触发近- UFP啮齿类动物的同时和对称面部运动。我们将开始 建立肌电图活动与正常啮齿动物面部运动之间的关系， 神经刺激和诱发的面部运动之间的关系，在假设 存在着一个数学模型，将电气和功能数据联系起来。然后我们将 构建肌电输入信号在线处理的控制算法，以驱动FES， 检查假设，这是可能的，以征服运动的一侧的脸， 另一侧的正常运动。重要的是，我们还将介绍近端神经 为了防止面部的不期望的生理激活， 肌肉组织，以模拟这些器械应用的临床相关场景。最后， 我们计划使用一种新型的植入式神经假体装置来实施FES范例 通过感应耦合供电，并证明无论是设备，存在 电极，也没有电刺激的应用诱导神经病变或肌病， 长期.从这项研究中获得的知识将立即影响到 在患有UFP的人类中实施类似系统，并提供重要的 促进运动神经元输入的重建以保留天然面部肌肉组织 严重的面部神经损伤此外，这里提出的新方法可以是 应用于其他临床场景-如功能性肌肉和神经转移-其中穷人 发生肌肉的控制和不希望的生理激活。

Project Summary The long-term goal of our research is to investigate mechanisms to restore and optimize facial movement in cases of facial paralysis. The specific goal of the proposed research is to develop and study the long-term feasibility of a functional electrical stimulation (FES) paradigm to restore dynamic symmetrical facial motion in a rodent model of unilateral facial palsy (UFP). We will utilize conductive polymer electrode arrays to detect normal rodent facial muscle EMG activity on one side of the face, and nerve cuff electrodes to evoke contralateral-side corresponding muscle activity. We will couple the two systems via an implantable signal acquisition and generation platform, and anticipate that digital signal processing can be applied to trigger near- simultaneous and symmetric facial movement in rodents with UFP. We will begin by establishing the relationship between EMG activity and normal rodent facial movement, and the relationship between neural stimulation and evoked facial movements, under the hypothesis that there exists a mathematical model that links electrical and functional data. We will then construct a control algorithm for online processing of EMG input signals to drive FES, to examine the hypothesis that it is possible to subjugate the movements on one side of the face to normal movements on the opposite side. Importantly, we will also introduce proximal neural blockade on the subjugated side in order to prevent undesired physiologic activation of the facial musculature, to mimic clinically relevant scenarios for the application of these devices. Finally, we plan to implement the FES paradigm using a novel implantable neuroprosthetic device powered through inductive coupling, and demonstrate that neither the device, the presence of electrodes, nor the application of electrical stimulation induces neuropathy or myopathy in the long term. Knowledge gained from this research would be of immediate impact to the implementation of an analogous system in humans suffering from UFP, and provide significant impetus for the re-establishment of motor-neuron input to preserve native facial musculature following severe facial nerve injury. Furthermore, the novel approach proposed here could be applied to other clinical scenarios – such as functional muscle and nerve transfers – where poor control and undesirable physiologic activation of a muscle occurs.