建立人工面神经反射弧恢复失神经支配眼轮匝肌的闭眼功能

目的：建立人工面神经反射弧，恢复面瘫兔的闭眼功能。 方法：试验动物为新西兰兔12只。采用手术切断面神经制备单侧周围性面瘫模型，患侧行肌电图检查确诊。术后第5天患侧植入刺激电极，健侧植入采集电极并留置1月。患侧分别于术后第7天、第28天给予电流刺激；而健侧采集电极则连续采集2周的肌电信号。建立健侧眼轮匝肌肌电信号采集、中枢信号处理模式识别、患侧电流刺激眼轮匝肌系统。当健侧眼轮匝肌采集的肌电信号经信号识别、提取以及电脑分析判断，符合其闭眼刺激阈值时，即对人工电刺激器发出指令，由刺激电极直接作用于患侧眼轮匝肌，引起眼睑完全闭合。结果：刺激方式为正负方向矩形波，电流强度为0.40—0.70mA之间可引起患侧眼轮匝肌收缩，眼睑完全闭合。当健侧眼睑闭合时，其肌电信号电压大于50uV，触发电刺激器，电流刺激即引发患侧眼轮匝肌收缩，完成眼睑闭合。结论：利用MEMS技术，在面瘫兔模型建立“人工面神经反射弧”，恢复患侧眼轮匝肌闭眼功能。

Artificial facial nerve reflex restores eyelid closure following orbicularis oculi muscle denervation

To date, treatment of peripheral facial paralysis has focused on preservation of facial nerve integrity. However, with seriously damaged facial nerve cases, it is difficult to recover anatomical and functional integrity using present therapies. Therefore, the present study utilized artificial facial nerve reflex to obtain orbicularis oculi muscle (OOM) electromyography signals on the uninjured side through the use of implanted recording electrodes. The implanted electrical chips analyzed facial muscle motion on the uninjured side and triggered an electrical stimulator to emit current pulses, which resulted in stimulation of injured OOM contraction and maintained bilateral symmetry and consistency. Following signal recognition, extraction, and computer analysis, electromyography signals in the uninjured OOM resulted in complete eyelid closure, which was consistent with the voltage threshold for eye closure. These findings suggested that artificial facial nerve reflex through the use of implanted microelectronics in unilateral peripheral facial paralysis could restore eyelid closure following orbicularis oculi muscle denervation.