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PubMed1979

Trigeminal neurotization of paralyzed facial musculature. Modification of the Lexer-Rosenthal surgical procedure.

We introduce a modification of the Lexer-Rosenthal surgical technique for reinnervation of the facial muscles by trigeminal neurolization in patients with facial paralysis. Four patients with such paralysis were seen in the Cranial Nerve Research Clinic, Oakland, Calif. Three of the four patients had their paralysis surgically treated, and recovery of facial motion was compared with that in one patient, in whom spontaneous trigeminal neurotization occurred. Those patients whose facial paralysis was surgically treated had fair to excellent results, and the technique is considered superior to alternative hypoglossal or spinal accessory anastomosis.

Adult↗

PubMedDate not supplied

Mimetic muscles and emotions: Hans Memling's fifteenth century masterpiece, "Last judgment," as a study for aesthetic surgery.

As the most recognizable part of the body, the face has always interested, not only artists, but doctors as well. Each has had their own perception of facial beauty. The task for plastic and aesthetic surgery regarding the face is to reconstruct, not only traumatic lesions, but also to prevent the effects of facial tissue aging. It is also important to preserve the aesthetic values of the face in different emotional conditions. Those conditions are partially represented by mimetic or facial muscles. One might suggest that the perception of human beings portrayed by the artists could be very helpful in the realm of plastic and aesthetic surgery. Take, for example, Hans Memling, a fifteenth century Flemish artist whose masterpiece "Last Judgment" is exhibited at Gdańsk National Museum in Poland. The fortunate individuals on the left side of the painting are queuing at heaven's gate to receive their reward. Their faces are smooth with smiles, displaying blessings and happiness. The right-hand side of the painting exemplifies the expression of fear and the drama of the situation. These sinners have been damned and sentenced to hell by evil creatures. The fear, pain, and tragedy of condemnation fill their faces. For plastic and cosmetic surgeons, studying the works of great artists has not been as valuable as using the emotionless and intangible figures of an anatomy book. Undoubtedly, the only useful paintings and sculptures are those that are full of expression with the face displaying a plethora of emotions. In all surgical approaches where mimetic muscles are concerned, one has to remember and be conscious of the fact that the face is a very significant part of our body.

Belgium↗

PubMedDate not supplied

The cosmetic use of botulinum toxin type B in the upper face.

Facial wrinkles involving the forehead, glabellar, and/or periorbital regions are a common esthetic problem and are directly related to overactivity of the underlying facial musculature. For instance, the development of glabellar wrinkles is related, at least in part, to the dynamics of the underlying procerus, corrugator supercilii, and orbicularis oculi muscles. Facial lines are considered problematic because they produce the appearance of aging. In some cases, they can also be misinterpreted as manifestations of negative emotions (eg, anger, anxiety, sadness), fatigue, or stress. In recent years, botulinum toxin injections have become one of the most popular therapies for the treatment of hyperfunctional facial lines. After injection, the toxin acts to paralyze or weaken facial mimetic muscles. This reduces or eliminates the appearance of wrinkles and is extremely safe.

Botulinum Toxins↗

PubMed1997

Identification of rat brainstem multisynaptic connections to the oral motor nuclei using pseudorabies virus. III. Lingual muscle motor systems.

The present experiments complete our investigations of higher order afferent control of the orofacial muscles by examining the premotor systems controlling the lingual musculature. Pseudorabies virus (PRV) was injected into the extrinsic (protruders: genioglossus and geniohyoid; retractors: hyoglossus and styloglossus) and intrinsic tongue muscles in bilaterally sympathectomized rats. Injection volumes ranged from 1 to 12 microl with average titers of 4 x 10(8) pfu/ml and maximum survival times of 90 h. Consistent labeling patterns and distributions occurred across each of the individual muscles and between extrinsic and intrinsic muscle groups, as well as in comparison to the results from the previous masticatory and facial muscle experiments. Virus injections produced a predictable myotopic labeling pattern in the hypoglossal nucleus (Mo 12). Transneuronally labeled neurons occurred in regions known to project directly to Mo 12 motoneurons including the nucleus subcoeruleus, trigeminal sensory areas, parvicellular reticular formation, and the dorsal medullary reticular fields. Maximum survival times revealed more distant connections from medial and lateral reticular zones including the periaqueductal gray, dorsal raphe, laterodorsal and pedunculopontine tegmental areas, and substantia nigra in the midbrain, the gigantocellular region, pontine nucleus caudalis and ventralis, and lateral paragigantocellular region in the pons, and the nucleus of the solitary tract, paratrigeminal region, and paramedian field in the medulla. Thus, injections of PRV into the orofacial muscles revealed a complex, but remarkably uniform network of multisynaptic connections in the brainstem that control and coordinate the activity of the masticatory, facial, and lingual muscles.

Animals↗

PubMed1984

Muscle transposition for facial reanimation. Indications and results.

The technique of transposing the temporalis and masseter muscles to reanimate the face following long-standing facial paralysis was introduced at the turn of the century. More recently it has been popularized by Rubin and Conley. The indications for performing this technique are outlined, and the results are analyzed.

Adolescent↗

PubMed2006

Application of facial electromyography in computer mouse access for people with disabilities.

PURPOSE: This study develops a newly facial EMG human-computer interface for people with disabilities for controllng the movement of the cursor on a computer screen. METHOD: We access the computer cursor according to different facial muscle activity patterns. In order to exactly detect the muscle activity threshold, this study adopts continuous wavelet transformation to estimate the single motor unit action potentials dynamically. RESULT: The experiment indicates that the accuracy of using the facial mouse is greater than 80%, and this result indicates the feasibility of the proposed system. Moreover, the subject can improve performance of manipulation by repeated training. CONCLUSION: Compared with previous works, the proposed system achieves complete cursor function and provides an inexpensive solution. Although there are still some drawbacks in the facial EMG-based human-computer interface, the facial mouse can provide an alternative among other expensive and complicated assistive technologies.

Persons with Disabilities↗

PubMedDate not supplied

[A case of rigid man syndrome (stiff-man syndrome)].

The Authors describe a case of "stiff-man syndrome" accompanied by all clinical and laboratory examinations; they point out the unusual implication of facial muscles and briefly report pathogenic theories and diagnostical criteria of this syndrome.

Diagnosis, Differential↗

PubMed1992

[Observation of motorneuron after recovery from experimental facial nerve paralysis].

The localization of the motor neurons innervating facial muscles and the masseter muscle was examined by the retrograde horseradish peroxidase (HRP) technique. Ten microliters of 50% HRP was injected into the orbicularis oculi muscle, the orbicularis oris muscle, the zygomaticus muscle and the masseter muscle of rabbits. At 48 hours after the HRP injection, perfusion fixation was done through the left ventricule of the heart under general anesthesia. The brain stem was removed and reacted with diaminobenzidine. The nucleus of the orbicularis oculi muscle was distributed in the medial-dorsal portion of the facial nerve nucleus. On the other hand, the nucleus of the orbicularis oris muscle and the nucleus of the zygomaticus muscle were located in the lateral-ventral, and medial-ventral portions, respectively. The nucleus of the masseter muscle (trigeminal motor nucleus) was located about 1.1mm proximal to the facial nucleus. Experimental facial nerve palsy was produced by the following procedures. The intratemporal facial nerve was exposed under local anesthesia and crushed for 20 sec. using a hemostatic forceps. Recovery from the facial nerve palsy was evaluated by evoked electromyography 3 months later. After another 3 months, HRP was injected into the zygomaticus muscle. In animals that had recovered from the facial palsy, motor neurons labeled with HRP were found not only in the medial-ventral portion but also partially in the medial-dorsal portion, which was the position of the labeled nucleus of the orbicularis oculi muscle in control animals. However, there was no significant difference in the size or number labeled motor neurons between the control and recovered animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMedDate not supplied

[Articulation disorder as the initial manifestation of facioscapulohumeral muscular dystrophy in childhood].

A five year old boy who had received logopedic treatment for more than two years was seen as an outpatient because of speech retardation. He presented with myopathic face, incomplete closure of both lids and severe weakness of facial muscles, bilateral winging of scapulae and hyperlordosis. Extraocular and pharyngeal muscles were not affected. Motor and sensory nerve fibre conductions and electromyography were within normal limits. CPK was moderately elevated (320 U/I). Muscle biopsy of right deltoid muscle revealed unspecific myopathic changes. The patients brother aged 7 also presented with facial weakness, elevated CPK and neurogenic changes in EMG of deltoid muscle. Both parents were clinically and electrophysiologically unremarkable. Although problems to speak distinctly are usually not the first manifestation, we found in this family facio-scapulo-humeral muscular dystrophy.

Arm↗

PubMed2001

A repressive coping style and affective, facial and physiological responses to looking at emotional pictures.

Previous studies have demonstrated increased physiological-emotional responses despite relatively low self-reported affect for individuals with a repressive coping style, as compared to control groups. The main question in the current study was whether such group differences could also be demonstrated by using the picture perception methodology of Lang. A second question was whether differences between these groups could be found in the habituation of physiological and emotional responses. Repressors (n=14), 'truly' low anxious participants (n=14), and moderately high anxious participants (n=13) were selected with the Marlowe-Crowne Social Desirability Scale and the Taylor Manifest Anxiety Scale. Two sets of 27 pictures with alternating neutral, threatening and sexual content were presented whilst valence and arousal ratings, skin conductance, heart rate and facial muscle responses were measured. No straightforward group differences were found. However, the results suggest that differential habituation, and not a repressive coping style, may contribute to differential self-reported, facial and physiological-emotional responses.

Adaptation, Psychological↗

PubMed1990

Effect of additional cations on the twitching reaction to intracarotid, nonionic contrast media in rabbits.

Previous investigations in this laboratory have confirmed the observation of facial muscle twitching during intracarotid injections of nonionic contrast media (CM) in rabbits. The reaction appears to be a locally mediated effect. To further investigate this reaction, cortical electroencephalogram (EEG) and facial electromyogram (EMG) recordings were made from rabbits receiving selective internal carotid artery (ICA) and external carotid artery (ECA) injections of CM. The effects of iopromide and iohexol were compared with and without the addition of sodium (Na) and calcium (Ca) ions at different concentrations. External carotid injections of iopromide also were performed in some animals paralyzed with D-tubocurarine to exclude the possibility that the reaction is due to an effect on peripheral nerves. The addition of between 5 and 20 mM Ca ions to both CM prevented the reaction but while the addition of Na ions (up to 150 mM) to iopromide had some preventative effect, it did not totally abolish the reaction. In those animals paralyzed with D-tubocurarine, the reaction to iopromide, as observed and recorded by EMG, was the same as that occurring in nonparalyzed animals. This finding is consistent with this reaction being independent of the peripheral nervous system.

Animals↗

PubMed1995

Electrically induced blink reflex and clinical blinking ability in patients with amyotrophic lateral sclerosis.

A study of the electrically induced blink reflex was performed on 17 patients with amyotrophic lateral sclerosis (ALS), graded according to the voluntary and reflexive blinking ability. In the early stage, delay of bilateral R2 latencies, decrease of bilateral R2 amplitudes and disappearance of the contralateral R2 component occurred. Then, the ipsilateral R2 component vanished when the voluntary blinking was incomplete. In cases with the remaining R2 component, the recovery curves of R2 amplitude revealed the weakened influence of the central nervous system to the interneurons that constructed the R2 component. In highly impaired patients who had lost the reflexive blinking ability, the R1 component had disappeared. Electrically induced blink reflex is useful in assessing the degree of disability in the upper facial muscles.

Adult↗

PubMed1993

Low-threshold motor effects produced by stimulation of the facial area of the fifth somatosensory cortex in the cat.

The motor effective sites of the fifth somatosensory cortex (SV) in the cat were mapped in detail by using unit recording and intracortical microstimulation (ICMS) techniques. The motor effective sites for facial muscle contraction were identified using stimulus currents of less than 30 microA. Of the 257 effective sites detected, 49% were activated by stimulus currents of less than 20 microA and of these, 51% responded to stimulus currents of less than 10 microA. ICMS within the facial area of the SV neuron produced contralateral eye-blinking, the lowest threshold current for which was 2 microA and ICMS within the SV neurons produced whisker movements, the minimum threshold current for which was 4 microA. Furthermore, stimulation of some SV neurons at a threshold current as low as 4 microA produced whisker movements and some responded to both visual and cutaneous stimuli. Ablation of areas 6a beta, 3a, SII, SIII and the motor cortex did not eliminate or reduce the low-threshold responses elicited by this weak stimulation of the SV. These motor effective areas receive input from the contralateral cutaneous of the surrounding muscle motor effective region. Our results suggest that the described effect is independent of motor effective areas.

Animals↗

PubMed1992

Perioral reflexes in orofacial dyskinesia and spasmodic dysphonia.

In order to assess the clinical utility of trigemino-facial reflexes in lower facial muscles, we studied perioral reflexes to mechanical and electrical stimulation in 13 patients with spasmodic dysphonia and orofacial dyskinesia and in 7 healthy subjects. Mechanical stimulation of the upper lip of all patients and electrical stimulation of the infraorbital nerve of patients with orofacial dyskinesia elicited larger perioral reflexes than in controls. In the majority of patients, hyperexcitable perioral reflexes were accompanied by increased gain of the blink reflex. In 4 patients, however, trigemino-facial reflexes were enhanced selectively in either the perioral muscles or orbicularis oculi. Our findings suggest that the quantitative assessment of perioral reflexes may provide information about the excitability of brainstem interneurons in cranial dystonia that is complementary to blink reflex studies.

Blinking↗

PubMed2003

Endoscopic dissection of recipient facial nerve for vascularized muscle transfer in the treatment of facial paralysis.

In order to prepare recipient facial nerve branches for neurovascular muscle, transfer in the treatment of facial paralysis, endoscopic facial nerve dissection was employed. Under endoscopy recipient facial nerve branches innervating the zygomaticus major muscle were successfully dissected. A stab incision was sufficient for nerve suture with the donor nerve. This method is preferable for young or female patients in whom conventional cheek incisions should be avoided.

Adolescent↗

PubMed1997

Connections of the caudal ventrolateral medullary reticular formation in the cat brainstem.

A region of the caudal ventrolateral medullary reticular formation (CVLM) participates in baroreceptor, vestibulosympathetic, and somatosympathetic reflexes; the adjacent retroambigual area is involved in generating respiratory-related activity and is essential for control of the upper airway during vocalization. However, little is known about the connections of the CVLM in the cat. In order to determine the locations of terminations of CVLM neurons, the anterograde tracers Phaseolus vulgaris leucoagglutinin and tetramethylrhodamine dextran amine were injected into this region. These injections produced a dense concentration of labeled axons throughout the lateral medullary reticular formation (lateral tegmental field), including the retrofacial nucleus and nucleus ambiguus, regions of the rostral ventrolateral medulla, the lateral and ventrolateral aspects of the hypoglossal nucleus, nucleus intercalatus, and the facial nucleus. A smaller number of labeled axons were located in the medial, lateral, and commissural subnuclei of nucleus tractus solitarius, the A5 region of the pontine reticular formation, the ventral and medial portions of the spinal and motor trigeminal nuclei, locus coeruleus, and the parabrachial nucleus. We confirmed the projection from the CVLM to both the rostral ventrolateral medulla and lateral tegmental field using retrograde tracing. Injections of biotinylated dextran amine or Fluorogold into these regions resulted in retrogradely labeled cell bodies in the CVLM. However, the neurons projecting to the lateral tegmental field were located mainly dorsal to those projecting to the rostral ventrolateral medulla, suggesting that these neurons form two groups, possibly with different inputs. Injections of retrograde tracers into the lateral tegmental field and rostral ventrolateral medulla also produced labeled cell bodies in other regions, including the medial and inferior vestibular nuclei and nucleus solitarius. These data are consistent with the view that the CVLM of the cat is a multifunctional area that regulates blood pressure, produces vocalization, affects the shape of the oral cavity, and elicits contraction of particular facial muscles.

Animals↗

PubMed1998

A re-evaluation of the mechanism of action of botulinum toxin on facial movement disorders in man.

Despite a lot of research aimed at clarifying the mechanism of action of botulinum toxin, mostly at supraspinal levels, a complete understanding of it is still elusive. However, recent investigations, including our own, allow us to suggest that, in facial muscles, the effects of botulinum toxin are not only in the neuromuscular junctions affecting the acetylcholine release but also modify the sensory inflow with subsequent changes on the muscle spindle-gammamotoneuron system.

Animals↗

PubMed1995

Muscle-specific enzyme activity patterns of the capillary bed of human oro-facial, masticatory and limb muscles.

Enzyme-histochemical methods were used to analyse the activities of alkaline phosphatase (AP), dipeptidylpeptidase IV (DPP IV) and adenosine triphosphatase (ATPase) in capillaries of four different human oro-facial muscles, the major and minor zygomatic, the orbicularis oris and buccinator, one masticatory, the masseter and two limb muscles, the biceps brachii and first dorsal interosseus muscles. In all muscles, except for the orbicularis oris, the majority of the capillaries lacked enzyme activity. Therefore, none of these enzymes seems to be reliable as a general marker for human muscle capillaries. In general, the capillaries of the limb muscles and the major and minor zygomatic and the buccinator, were similar in their staining pattern for AP and ATPase, but differed in DPP IV staining. The orbicularis oris muscle differed from the other muscles by showing the largest proportion of capillaries with AP and ATPase activity. The masseter muscle had the largest proportion of capillaries stained for DPP IV. The muscle specific differences in enzyme activity of the capillaries are in agreement with our previous findings of specific differences between limb, oro-facial and masticatory muscles with respect to capillary supply and composition of fibre types and myosins. The results reflect functional specialization of the capillary bed of human muscles.

Adenosine Triphosphatases↗