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Electrical Stimulation of Atropic Designation Nerves and Reinnervated Facial Muscles as Means of Recovery Process of Mimic Motor Acts


Affiliations
1 Scientific and Technological Centre of Unique Instruments of Russian Academy of Sciences, Butlerov str. 15, 117342, Moscow, Russian Federation
2 Central Scientific Institute of Stomatology and Maxillo-Facial Surgery, T. Frunze str. 16. 119991, Moscow, Russian Federation
 

Objectives: To study the dynamics of recovery process of mimic motor acts of patients with facial droop after the removal of the cerebellopontine angle neurinoma and the subsequent reparative operation on the reinnervation of facial muscles by the masseteric branch of the trifacial nerve; to estimate the effect of electrical stimulation of atropic nerve and the reinnervated facial muscles on the dynamics of regenerative process of mimics. Methods: During the recovery period, the study patients were undergone transcutaneous electrical stimulation of atropic nerves and reinnervated facial muscles. A polyprogram stimulator with a set of special programs was designed and used for this therapy. In the neurostimulation (ENS) mode, the pulse duration was from 0.1 to 0.4 ms, the repetition rate was from 10 to 40 Hz, the current amplitude was from 2.0 to 4.5 mA. In the miostimulation (EMS) mode the pulse duration was from 0.4 to 0.5 ms, the repetition rate was from 3 to 20 Hz. The duration of the pulse series was from 1.0 to 6 seconds, the pause between the series was from 2 to 6 seconds, the current amplitude in the EMS mode was from 2 to 8 mA. Results: The recovery of motor acts starts from the muscles innervated by the fourth (submaxillary) branch of the facial nerve, then the activity of the muscles innervated by the third, second and, finally, the first (frontalis) branches is subsequently awakened. It was found that the application of the electrical stimulation according to the proposed programs considerably accelerates the regeneration process. The relative recovery time of motor acts within the group of study patients compared with the sham group decreased from 33 to 48 %. Conclusions: Postoperative transcutaneous electrical stimulation of atropic nerves and denervated facial muscles considerably accelerates the dynamics of restoration of functional activity of these muscles after their operative reinnervation.

Keywords

Dynamics of Regenerative Process, Electrical Stimulation, Facial Muscle, Facial Nerve, Motor Action
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  • Electrical Stimulation of Atropic Designation Nerves and Reinnervated Facial Muscles as Means of Recovery Process of Mimic Motor Acts

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Authors

V. L. Domanskiy
Scientific and Technological Centre of Unique Instruments of Russian Academy of Sciences, Butlerov str. 15, 117342, Moscow, Russian Federation
I. A. Sobakin
Scientific and Technological Centre of Unique Instruments of Russian Academy of Sciences, Butlerov str. 15, 117342, Moscow, Russian Federation
S. M. Koshelev
Scientific and Technological Centre of Unique Instruments of Russian Academy of Sciences, Butlerov str. 15, 117342, Moscow, Russian Federation
A. I. Nerobeyev
Central Scientific Institute of Stomatology and Maxillo-Facial Surgery, T. Frunze str. 16. 119991, Moscow, Russian Federation
M. M. Somova
Central Scientific Institute of Stomatology and Maxillo-Facial Surgery, T. Frunze str. 16. 119991, Moscow, Russian Federation

Abstract


Objectives: To study the dynamics of recovery process of mimic motor acts of patients with facial droop after the removal of the cerebellopontine angle neurinoma and the subsequent reparative operation on the reinnervation of facial muscles by the masseteric branch of the trifacial nerve; to estimate the effect of electrical stimulation of atropic nerve and the reinnervated facial muscles on the dynamics of regenerative process of mimics. Methods: During the recovery period, the study patients were undergone transcutaneous electrical stimulation of atropic nerves and reinnervated facial muscles. A polyprogram stimulator with a set of special programs was designed and used for this therapy. In the neurostimulation (ENS) mode, the pulse duration was from 0.1 to 0.4 ms, the repetition rate was from 10 to 40 Hz, the current amplitude was from 2.0 to 4.5 mA. In the miostimulation (EMS) mode the pulse duration was from 0.4 to 0.5 ms, the repetition rate was from 3 to 20 Hz. The duration of the pulse series was from 1.0 to 6 seconds, the pause between the series was from 2 to 6 seconds, the current amplitude in the EMS mode was from 2 to 8 mA. Results: The recovery of motor acts starts from the muscles innervated by the fourth (submaxillary) branch of the facial nerve, then the activity of the muscles innervated by the third, second and, finally, the first (frontalis) branches is subsequently awakened. It was found that the application of the electrical stimulation according to the proposed programs considerably accelerates the regeneration process. The relative recovery time of motor acts within the group of study patients compared with the sham group decreased from 33 to 48 %. Conclusions: Postoperative transcutaneous electrical stimulation of atropic nerves and denervated facial muscles considerably accelerates the dynamics of restoration of functional activity of these muscles after their operative reinnervation.

Keywords


Dynamics of Regenerative Process, Electrical Stimulation, Facial Muscle, Facial Nerve, Motor Action



DOI: https://doi.org/10.17485/ijst%2F2017%2Fv10i40%2F168460