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Morphological study of two human facial muscles: orbicularis oculi and corrugator supercilii.

Human facial muscles are unique in that they do not cross joints and they function either to open and close the apertures of the face or to tug the skin into intricate movements producing facial expressions. Compared to other skeletal muscles of the body, little is known about the microscopic architecture and organization of facial muscles. It was hypothesized that facial muscles with different roles would possess differences in their cellular organization and morphology that would reflect their unique function. The palpebral orbicularis oculi (oo) and the corrugator supercilii (cs) were studied because they are in close topographical proximity to one another and share the same nerve supply and embryonic origin. This study compared the two muscles which were procured as biopsies from cosmetic surgery procedures. Architectural and morphological features were elucidated using a combination of conventional histological stains, immunocytochemistry and histochemistry. Quantitative measures of fiber sizes, shapes, and fiber-type distributions were performed along with measures of capillary area per unit of contractile area (capillary index). Fiber-type profiles and motor end-plates were demonstrated by using antibodies to fast and slow myosins, as well as to neurofilament protein. The oo was shown to differ significantly from the cs on the basis of fiber shapes, sizes, and types. The oo muscle fibers were small, rounded, and 89% of them were of the fast-twitch (Type II) variety. The muscle fibers in the cs were larger, polygonal, and only 49% of them were of the fast-twitch variety. The capillary index of the cs was 2.4 times that of the oo.

Analysis of Variance↗

Detection of intraoperative laser injury to the facial nerve by electromyographic monitoring of facial muscles.

Injury to the facial nerve is a significant risk during resection of cerebellopontine angle tumors. To minimize the risk of facial nerve injury, intraoperative electromyographic monitoring of facial musculature is frequently used. However, the reliability of such monitoring systems for detection of thermal nerve injury resulting from the use of carbon dioxide lasers has not been systematically evaluated. We determined the sensitivity of a computerized electromyographic monitor for detection of laser facial nerve injury in an anesthetized rat model. The mandibular and buccal branches of the facial nerve were isolated in 12 rats. A carbon dioxide laser was used to create controlled sites of thermal injury to both nerves over a 3-hour period. When a laser injury was created distal to previous injury sites, electromyographic discharge was noted in 72% to 82% of injuries. Laser injury proximal to previous injury sites was detected with 33% efficiency. These detection rates did not change significantly over a 3-hour period. This preliminary data suggests that electromyographic monitoring of facial musculature allows detection of facial nerve injury caused by carbon dioxide lasers.

Animals↗

Oro-facial muscles: internal structure, function and ageing.

Structure and function are reviewed in the masticatory muscles and in the muscles of the lower face and tongue. The enormous strength of jaw closure is in large part due to the pinnated arrangement of the muscle fibres in the masseter. This muscle, like other masticatory muscles, is unusual in that the cell bodies of the muscle spindle afferents lie in the brain stem rather than in an external ganglion; spindles are absent in the lower facial muscles. Although few data are available, the numbers of motor units in the masticatory muscles, and probably in the lower facial muscles also, appear to be much greater than in limb muscles. The motor units in the facial and tongue muscles are largely composed of histochemical type II ('fast-twitch') fibres, but in the masticatory muscles there are substantial numbers of fibres intermediate between type I ('slow twitch') and type II, and fibre type grouping is present. In comparison with limb muscles, there is little information on ageing changes in oro-facial muscles. The masticatory muscles do, however, show some atrophy and loss of X-ray density, while motor unit twitches are prolonged. Strength is reduced in the tongue and masticatory muscles. It is known that limb muscle properties are largely governed by their innervation, both through the pattern and amount of impulse activity, and the delivery of trophic messengers; the situation for oro-facial muscles is unclear. The structural and functional differences between the two types of muscle indicate the need for conducting ageing studies on the oro-facial muscles, rather than relying on extrapolations from limb muscles.

Aged↗

Activity of peri-oral facial muscles and its coordination with jaw muscles during ingestive behavior in awake rabbits.

To study peri-oral facial muscle activity patterns and coordination with jaw muscles during ingestive behavior, electromyographic (EMG) activities in the peri-oral facial (buccinator: BUC, orbicularis oris: ORB) and jaw (masseter, digastric) muscles along with jaw movement trajectories were recorded in awake rabbits. A standardized amount of apple in a cylindrical shape was used as the test food. The period from food intake to just before swallowing (the masticatory sequence) was divided into three masticatory periods (preparatory period, rhythmic chewing period and preswallow period) based on the activity pattern of jaw muscles and jaw movement trajectories, and jaw movements and EMG activities in both the jaw and facial muscles during each masticatory period were assessed. Both the jaw and facial muscles were active throughout the masticatory sequence, and the activity patterns of facial muscles and the pattern of coordination between the facial and jaw muscles varied for each masticatory period. No consistent pattern was noted for the BUC activity during the preparatory period, whereas the ORB showed tonic activity throughout this period. During the rhythmic chewing and preswallow periods, both the ORB and BUC showed jaw-movement-related rhythmic bursts. However, significant differences were noted in the burst properties in both facial muscles and their temporal correlations with the jaw muscle activities between these two periods. Results suggest that the neural mechanisms regulating facial muscle activities may differ between the masticatory periods, and such mechanisms may contribute to the well-coordinated orofacial movements required for smooth masticatory sequence.

Analysis of Variance↗

Functional organisation of corticonuclear pathways to motoneurones of lower facial muscles in man.

EMG responses were recorded from lower facial muscles (depressor labii inferioris or depressor anguli oris) of 12 normal subjects after magnetic stimulation of the motor cortex. Using a figure-of-eight stimulating coil, the largest responses were obtained from points around 8-10 cm lateral to the vertex. Usually they were bilateral and had the same latency (11-12 ms) on both sides of the face. Patients with complete Bell's palsy had no response in muscles on the same side as the lesion, indicating that the ipsilateral component to cortical stimulation was not the result of recrossing in the periphery of nerve fibres from the contralateral side. Single-unit studies showed that cortical stimulation produced two phases of motoneuronal facilitation: a short-latency (central motor delay from contralateral cortex to the intracranial portion of the facial nerve, 7.6 ms), short-duration (1- to 2-ms duration peak in the post-stimulus time histogram) input, which was more commonly evoked by contralateral than ipsilateral stimulation; and a longer latency (central delay > 15 ms), long-duration input evoked equally well from either hemisphere. The former may represent activity in a predominantly contralateral oligosynaptic corticobulbar pathway; the latter, a polysynaptic indirect (e.g. cortico-tegmento-nuclear) bilateral pathway to lower facial muscles.

Adult↗

Electroneurographic facial muscle pattern in Bell's palsy.

To study the electroneurographic facial muscle pattern in Bell's palsy over time, electroneurographic recordings in the frontalis, orbicularis oculi, nasalis, and mentalis muscle regions were performed early (mean, day 11) and 1 and 3 months after the onset of the condition in 30 consecutive patients. The correlation between facial muscle electroneurographic recordings over time was also calculated. An additional aim was to assess whether further prognostic information could be obtained by electroneurographic recordings in more than one facial region. The recovery pattern was similar in all 4 facial regions. Initially, the correlation between the facial recordings was weak (r = 0.20-0.27), but it was improved at follow-up examinations (r = 0.33-0.65). Favorable outcome in 23 of 24 patients (96%) could have been predicted by the initial nasalis and/or mentalis recordings. The gap between patients with favorable outcome and patients with unfavorable outcome increased when the average electroneurography values were calculated from 1, 2, and 4 muscle recordings (4%, 8%, and 15%, respectively). Our results indicate that in Bell's palsy, electroneurographic examination of more than one facial muscle region may add prognostic information and that the degree of degeneration is initially different in the nerve branches.

Action Potentials↗

Paralysis of facial muscles in leprosy patients with lagophthalmos.

The objective of the study was to determine the pattern of involvement of facial muscles in lagophthalmos. Fifty-seven patients with lagophthalmos were examined to assess the degree of paralysis of facial muscles. Eighty-one percent of the patients with lagophthalmos had involvement of at least one other muscle group. In patients with lagophthalmos with a gap at mild closure of 5 mm or more, 27 of 30 (90%) had involvement of at least one other facial muscle. In lepromatous leprosy the pattern of involvement was symmetrical and "patchy," the right and left sides being affected equally. In tuberculoid leprosy, the ipsilateral muscles were more often involved, which is the pattern of involvement of a nerve trunk. The upper and lower facial muscles were affected in the same proportion. Hence, on clinical grounds, there is little support for the often postulated statement that the superficial course of the facial nerve above the zygomatic bone is decisive for exclusive paralysis of the zygomatic branch of the facial nerve.

Adult↗

Patterns of activity of perioral facial muscles during mastication in man.

The activity of buccinator, orbicularis oris superior and inferior, quadratus and triangularis muscles was recorded by surface and needle electrodes during spontaneous unilateral mastication of small or large boluses. Their activity was compared with that of the masticatory muscles masseter and digastric, and with the vertical movement of the jaw. The facial muscles were active during mastication, displaying both tonic and phasic activity. Although the cyclic activity was broadly linked to lowering of the jaw, there was no strict time correspondence between the activity of the various facial muscles themselves, or between the activity of the facial muscles and the digastric. The timing and amplitude of facial muscle activity were affected by the duration of the masticatory cycle, the side on which chewing took place, the size of the bolus, and whether or not lip to lip contact was made.

Adult↗

The simultaneous use of electrocochleogram, brainstem auditory evoked potential and facial muscle EMG in cerebellopontine angle tumor removal.

In six cases of acoustic neurilemmoma, electrocochleogram (ECOchG), brainstem auditory evoked potentials (BAEP) and facial muscle electromyograms (EMG) were recorded to monitor facial nerve and brainstem function. Under isoflurane and nitrous oxide anesthesia, we recorded ECOchG from the tympanic membrane, BAEP from the scalp needle, and facial muscle EMG from the mentalis muscle. During surgery, the body temperature was kept above 36.5 degrees C, and PaCO2 above 30 mmHg. In all cases, the peak N1 of ECOchG and wave I of BAEP had identical latencies throughout the monitoring period. The response was faster and the amplitude was higher in the ECOchG recordings. For calculation of the I-III or I-V interpeak latency of BAEP, the wave I of BAEP could be confirmed more quickly and precisely by the peak N1 of ECOchG. During tumor removal, the embedded facial nerve pathway in the tumor was identified by electric stimulation of the intracranial facial nerve, followed by evoked facial muscle EMG. Facial nerve function was confirmed by nerve traction or direct electric stimulation after total removal of the tumor. No facial palsy or other neurologic sequelae was found after the operations.

Adult↗

Functional muscle partitioning during voluntary movement: facial muscle activity for speech.

Electromyographic activity was recorded from multiple intramuscular sites in the orbicularis oris muscle for a set of speech and other motor tasks. Because of its geometric heterogeneity and multiple functions, it was hypothesized that this muscle might be partitioned in a task-dependent manner. Comparison of the timing and amplitude of the EMG activity among the multiple recording sites supported this hypothesis. Because some facial motoneurons in primates, including humans, are monosynaptically activated from area 4 of the motor cortex, it is suggested that this task-dependent muscle partitioning may reflect an aspect of cortical organization.

Adult↗

The expression kinetics of myogenin in facial muscle denervation.

OBJECTIVE: To study the expression kinetics of myogenin in long-term denervated facial muscle and to explore the possibility of gene therapy for facial muscle paralysis with myogenin gene. MATERIALS AND METHODS: In 48 New Zealand rabbits, buccal muscle paralysis of one side was produced by excision of 1 cm segment buccal branch of the facial nerve. The opposite side served as controls. The animals were sacrificed and the buccal muscles of both sides were removed for examination at 1 day, 3 days, 1 week, 2 weeks, 1 month, 2 months, 4 months, and 6 months after the initial operation. The myogenin expression in denervated and innervated buccal muscles was analyzed by Western blot. Satellite cell proliferation was detected with proliferating cell nuclear antigen (PCNA) analysis. Muscle nucleic acid concentration was determined through acridine orange (AO) staining method. RESULTS: Myogenin expression increased to the highest level at 3 days after denervation, thereafter it gradually decreased. The Western blotting signal for myogenin intensified again after 1 month and at 4 months. In contrast, the highest expression of the controls (innervated muscles) were observed at 1 month. These changes in myogenin expression in denervated buccal muscles were consistent with the change in satellite cell proliferation and in muscle nucleic acid concentration. CONCLUSION: Myogenin protein expression in longterm facial muscle denervation is closely associated with satellite cell regeneration. Myogenin may promote satellite cell differentiation, and therefore may improve the treatment of facial paralysis.

Acridine Orange↗

F-waves of the facial muscles in healthy control subjects and in patients with peripheral facial nerve disturbance.

F-waves were recorded from the mentalis muscles with surface electrodes following stimulation of the marginal mandibular branch of the facial nerve in healthy control subjects during wakefulness, non-REM (rapid eye movement) sleep and voluntary contraction and in patients with Bell's palsy and acoustic neurinoma. The F-wave of the facial muscles results from the backfiring of antidromically activated alpha motoneurons in the facial motonucleus. Therefore, first, the F-waves were not easily elicited in patients with any disturbance in the proximal segment of the facial nerve (Bell's palsy and acoustic neurinoma). Second, the F-waves were affected by excitability of the facial motonucleus; the F-waves were inhibited significantly during sleep and enhanced significantly during voluntary contraction compared with those at rest during wakefulness. When the stimulation strength was set submaximum for M-waves, F-waves were elicited but H-waves, which have lower threshold than M-waves, were not elicited in the facial muscles, unlike the case of the extremities. Measurement of the F-waves of facial muscles is a new method for estimating excitability of the facial motonucleus unless there is any disturbance of the proximal segment. Fundamental characteristics of the facial F-waves were shown in the present study and measuring facial F-waves is clinically applicable for investigation of both excitability of the facial motonucleus and facial peripheral nerve disturbance.

Adult↗

[Functional reconstruction with tissue engineered myoblast in facial muscle of rat].

OBJECTIVE: The purpose of this article is to discuss the reconstruction of facial muscle defects with tissue engineered myoblast in SD rats. METHODS: Using purified, subcultured myoblast of neonatal rats and type I collagen gels as extracellular matrix (ECM) and scaffold, tissue engineered muscle was transplanted in the face of syngeneic nutured rats. RESULTS: Tissue engineered myoblast generated and differentiated in vitro were observed with microscope. Myoblast fused each other and formed myofibers in the face of rats, nerve fibers and vessels regeneration could also be found in some samples. Postoperative electromiographs showed the myofibers were active when stimulating the nerve trunk that innervates the engineered facial muscle. CONCLUSION: Tissue engineered method is hopeful to be used as a new technique to reconstruct defects of facial muscle.

Animals↗

[Apoptosis and expression of apoptosis-related proteins in experimental different denervated guinea-pig facial muscle].

OBJECTIVE: To study apoptosis and expression of apoptosis-related proteins in experimental different denervated guinea-pig facial muscle. METHOD: An experimental model was established with guinea pigs by compressing the facial nerve 30 second (reinnervated group) and resecting the facial nerve (denervated group). TUNEL method and immunohistochemical technique (SABC) were applied to detect the apoptosis and expression of apoptosis-related proteins bcl-2 and bax from 1st to 8th week after operation. RESULT: Experimentally denervated facial muscle revealed consistently increase of DNA fragmentation, average from(34.4 +/- 4.6)% to (38.2 +/- 10.6)%, from 1st week to 8th week after operation; Reinnervated facial muscle showed a temporal increase of DNA fragmentation, and then the muscle fiber nuclei revealed decreased DNA fragmentation along with the function of facial nerve recovered, latterly normal, average from (32.0 +/- 8.03)% to (5.6 +/- 3.5)%, from 1st week to 8th week after operation. In denervated group, bcl-2 and bax were expressed strongly; in reinnervated group, bcl-2 expressed consistently, but bax disappeared latterly along with the function of facial nerve recovered. CONCLUSION: Expression of DNA fragmentation and apoptosis-related proteins in denervated muscle are general reaction to denervation. bcl-2 can prevent early apoptotic muscle fiber to survival until reinnervation. It is concluded that proteins control apoptosis may give information for possible therapeutic interventions to reduce the rate of muscle fiber death in denervated atrophy in absence of effective primary treatment.

Animals↗

Correlation of compound action potential and electromyography with facial muscle tension.

Functional electric stimulation is a new method for dynamic rehabilitation of paralyzed muscles. The output of such prosthetic devices needs to be modulated by some index of the muscle movement. In facial paralysis a measure of the muscle contractions of the normal contralateral side seems to be an appropriate input. In the rabbit, we simultaneously measured the compound action potential of the buccal branch of the facial nerve, the electromyogram of the zygomaticus major muscle, and the muscle twitch tension through strain gauge. The compound action potential, electromyogram, and strain gauge each had a sigmoidal relationship to stimulus intensity. The compound action potential peak-to-peak amplitude was found to have a linear correlation to the peak twitch tension of the corresponding facial muscle. The electromyogram response, although more variable, also had a linear correlation with muscle contraction. The possibility of predicting the contraction of facial muscles before they actually occur is discussed in the context of available and future functional electric rehabilitation models.

Action Potentials↗

Measurement of facial muscle strength in normal subjects.

OBJECTIVES: Muscle strength is a fundamental measure of function for neuromuscular systems; however, mimetic facial muscle strength has never been recorded. The objective of the present feasibility project was to measure facial muscle strength. STUDY DESIGN: The study design was a prospective experimental trial in 10 normal subjects. Descriptive statistics, tests, and analysis of variance were used to summarize and compare data. METHODS: Subjects were selected by convenience following submission and approval of a prospectively designed protocol and consent form to the Human Studies Committee. Application of a force transducer to the central eyebrow and commissure during eyebrow raising, eyelid closing, smiling, and puckering was performed by two methods: surface adhesion method (n = 5) and direct probe application method (n = 5). Data were recorded in pounds. Three repetitions of each movement were made. RESULTS: Rank order of muscle strengths (in pounds) by the surface adhesion technique was as follows: brow, 0.758; eye, 0.549; pucker, 0.387; and smile, 0.307. By direct probe application the rank order of muscle strengths was as follows: eye, 0.880; brow, 0.773; and smile, 0.730. CONCLUSIONS: Objective measures of facial motion are crucial for quantitative investigations of preventative, therapeutic, reconstructive, and rehabilitative interventions for facial nerve and muscle lesions. Until the present, objective measures required cross-correlations with current standards that were subjective. This is the first time an actual physical measure of facial muscle function has been performed. The purpose of presenting this preliminary work is to stimulate advancement along this line of research.

Adult↗

The development of facial motoneurones in the mouse--neuronal death and the innervation of the facial muscles.

The relationship between neuronal death and the formation of patterned connections was studied in the facial neuromuscular system of foetal, neonatal, and adult mice. The facial neuromuscular system was selected because two large, widely separated, facial muscles (the nasolabial and posterior auricular muscles) are innervated by clearly separated parts of the facial motor nucleus in the adult mouse. The number of motorneurones in the facial nucleus was counted in Nissl-stained sections at different stages of development. Over 6400 neurones were present in the facial nucleus at day 17 p.c. (post-coitum). After day 17 p.c. the number of neurones fell rapidly and only 2000 cells remain in the adult nucleus. This represents a loss of 68%, most of which occurs between days 18 and 20 p.c. Neurones with pyknotic nuclei are seen on day 17 p.c. and are most numerous on day 18 p.c. This leads us to believe that the fall in neurone numbers is due to cell death. Indirect evidence provided by acetylcholinesterase histochemistry (time of earliest reaction in the facial muscles) and horseradish peroxide (HRP) tracing studies (time of earliest transport) indicate that facial motorneurone axons innervate the facial musculature before the period of cell death: diffuse acetylcholinesterase activity first appeared in the auricular muscles at day 15 p.c. and in the nasolabial muscles at day 17 p.c.; retrograde transport of HRP from the auricular and nasolabial muscles to the facial nucleus cannot be reliably demonstrated before day 17 p.c. We assessed the topography of early facial neuromuscular innervation by making HRP injections into nasolabial and posterior auricular muscles of embryonic and neonatal mice. Injections of HRP at day 17 p.c. (the day before cell loss commenced) showed that the nasolabial muscle and posterior auricular muscles were innervated by the same subnuclei of the facial nucleus as in the adult--except that there was a small number (1-5%) of labelled cells located in parts of the nucleus not consistent with the adult innervation pattern. These data indicate that, except for a small number of neurones, topographically organized connections in the facial neuromuscular system are established before the period of cell death. We conclude that motoneurone cell death does not play a major role in the establishment of topographically organized connections in this system.

Acetylcholinesterase↗