Surface electromyography of facial muscles during natural and artificial feeding of infants

Objective: To measure and compare the activity of the masseter, temporalis and buccinator muscles in different infant feeding methods. Method: Cross-sectional study of 60 full-term infants with no intercurrent diseases, aged between two and three months, classified into the following groups: 1) exclusive breastfeeding; 2) breastfeeding plus bottle-feeding; and 3) exclusive breastfeeding plus cup feeding. Surface electromyography was performed during infant feeding. The Krushal-Wallis test was used, complemented by multiple paired comparisons of the groups. A 5% significance level was chosen for the tests. Results: Statistically higher results were verified in the breastfeeding group in relation to the bottle-feeding one, both in the range of movement and the mean contraction of the masseter. With regard to the temporalis muscle, statistically higher results were found in the breastfeeding group comparatively to the bottle-feeding one. As to the buccinator muscle, statistically higher results were observed in the breastfeeding group in relation to the bottle-feeding one, although in this case, the difference concerned only the range of contraction. Conclusion: The similarities between the muscle activity in the breastfeeding and in the cup-feeding groups suggests that cup-feeding can be used as an alternative infant feeding method, being better than bottle-feeding, due to the hyperactivity of the buccinator muscle, which could result in changes to the structural growth and development of the stomatognathic system functions. Copyright © 2006 by Sociedade Brasileira de Pediatria.

Uncrossed cortico-muscular projections in humans are abundant to facial muscles of the upper and lower face, but may differ between sexes

It is a popular concept in clinical neurology that muscles of the lower face receive predominantly crossed cortico-bulbar motor input, whereas muscles of the upper face receive additional ipsilateral, uncrossed input. To test this notion, we used focal transcranial magnetic brain stimulation to quantify crossed and uncrossed cortico-muscular projections to 6 different facial muscles (right and left Mm. frontalis, nasalis, and orbicularis oris) in 36 healthy right-handed volunteers (15 men, 21 women, mean age 25 years). Uncrossed input was present in 78% to 92% of the 6 examined muscles. The mean uncrossed: crossed response amplitude ratios were 0.74/0.65 in right/left frontalis, 0.73/0.59 in nasalis, and 0.54/0.71 in orbicularis oris; ANOVA p>0.05). Judged by the sizes of motor evoked potentials, the cortical representation of the 3 muscles was similar. The amount of uncrossed projections was different between men and women, since men had stronger left-to-left projections and women stronger right-to-right projections. We conclude that the amount of uncrossed pyramidal projections is not different for muscles of the upper from those of the lower face. The clinical observation that frontal muscles are often spared in central facial palsies must, therefore, be explained differently. Moreover, gender specific lateralization phenomena may not only be present for higher level behavioural functions, but may also affect simple systems on a lower level of motor hierarchy.

Cytoarchitecture and musculotopic organization of the facial motor nucleus in Cebus apella monkey

The architecture and musculotopic organization of the facial motor nucleus in the Cebus apella monkey (a New World primate) were investigated using histological techniques and a multiple labelling strategy, in which horseradish peroxidase-conjugated neuroanatomical tracers (CTB-HRP and WGA-HRP) and fluorescent tracers were injected into individual facial muscles. The facial motor nucleus was formed by multipolar motoneurons and had an ovoid shape, with its rostrocaudal axis measuring on average 1875 mum. We divided the nucleus into four different subnuclei: medial, intermediate, dorsal and lateral. Retrograde labelling patterns revealed that individual muscles were innervated by longitudinal functional columns of motoneurons. The columns of the orbicularis oculi, zygomaticus, orbicularis oris, auricularis superior, buccinator and platysma muscles were located in the dorsal, intermediate, lateral, medial, lateral and intermediate subnuclei, respectively. However, the motoneuron columns of the levator labii superioris alaeque nasi muscle and frontalis muscle could not be associated with a specific subnucleus. The present results confirm previous studies regarding the musculotopic organization of the facial motor nucleus. However, we observed some particularities in terms of the relative size of each column in C. apella, which might be related to the functional and behavioral importance of each muscle in the particular context of this primate.

Autologous orbicularis muscle for filling facial foldsan experimental and clinical study

Purpose: To present a technique for filling facial folds by using autologous orbicularis oculi muscle, based on an experimental model. Methods: two studies are presented: (1) an experimental study using 15 albino guinea-pigs from which a strip of the sural triceps muscle was removed and implanted in the subcutaneous tissue of the dorsal area. The animals were sacrificed 7, 30 and 60 days after the implantation, and the material was histologically evaluated. And (2%) an interventional prospective clinical trial carried out on 20 patients referred to blepharoplasty surgery. They received autologous preseptal orbicularis muscle for filling facial folds. The results where evaluated by patients satisfaction and clinical exam. Results: the sural tricep muscle, when implanted in the subcutaneous tissue, resulted in fibrosis. The patients whom received autologous orbicularis muscle implanted for filling facial folds showed that the procedure can be successfully carried out. Conclusions: autologous preseptal orbicularis muscle is a good material for filling facial folds. Cicatricial tissue will be formed on its implantation site, filling the tissue gap that forms the folds on the skin.

Anatomically-Driven Soft-Tissue Simulation Strategy for Cranio-Maxillofacial Surgery Using Facial Muscle Template Model

We propose a computationally efficient and biomechanically relevant soft-tissue simulation method for cranio-maxillofacial (CMF) surgery. A template-based facial muscle reconstruction was introduced to minimize the efforts on preparing a patient-specific model. A transversely isotropic mass-tensor model (MTM) was adopted to realize the effect of directional property of facial muscles in reasonable computation time. Additionally, sliding contact around teeth and mucosa was considered for more realistic simulation. Retrospective validation study with postoperative scan of a real patient showed that there were considerable improvements in simulation accuracy by incorporating template-based facial muscle anatomy and sliding contact.

Classificação de atividade eletromiográfia facial de indivíduos saudáveis e com hanseníese por meio de máquina de vetores de suporte

A number of studies in the areas of Biomedical Engineering and Health Sciences have employed machine learning tools to develop methods capable of identifying patterns in different sets of data. Despite its extinction in many countries of the developed world, Hansen’s disease is still a disease that affects a huge part of the population in countries such as India and Brazil. In this context, this research proposes to develop a method that makes it possible to understand in the future how Hansen’s disease affects facial muscles. By using surface electromyography, a system was adapted so as to capture the signals from the largest possible number of facial muscles. We have first looked upon the literature to learn about the way researchers around the globe have been working with diseases that affect the peripheral neural system and how electromyography has acted to contribute to the understanding of these diseases. From these data, a protocol was proposed to collect facial surface electromyographic (sEMG) signals so that these signals presented a high signal to noise ratio. After collecting the signals, we looked for a method that would enable the visualization of this information in a way to make it possible to guarantee that the method used presented satisfactory results. After identifying the method's efficiency, we tried to understand which information could be extracted from the electromyographic signal representing the collected data. Once studies demonstrating which information could contribute to a better understanding of this pathology were not to be found in literature, parameters of amplitude, frequency and entropy were extracted from the signal and a feature selection was made in order to look for the features that better distinguish a healthy individual from a pathological one. After, we tried to identify the classifier that best discriminates distinct individuals from different groups, and also the set of parameters of this classifier that would bring the best outcome. It was identified that the protocol proposed in this study and the adaptation with disposable electrodes available in market proved their effectiveness and capability of being used in different studies whose intention is to collect data from facial electromyography. The feature selection algorithm also showed that not all of the features extracted from the signal are significant for data classification, with some more relevant than others. The classifier Support Vector Machine (SVM) proved itself efficient when the adequate Kernel function was used with the muscle from which information was to be extracted. Each investigated muscle presented different results when the classifier used linear, radial and polynomial kernel functions. Even though we have focused on Hansen’s disease, the method applied here can be used to study facial electromyography in other pathologies.

Classificação de atividade eletromiográfia facial de indivíduos saudáveis e com hanseníase por meio de máquina de vetores de suporte

A number of studies in the areas of Biomedical Engineering and Health Sciences have employed machine learning tools to develop methods capable of identifying patterns in different sets of data. Despite its extinction in many countries of the developed world, Hansen’s disease is still a disease that affects a huge part of the population in countries such as India and Brazil. In this context, this research proposes to develop a method that makes it possible to understand in the future how Hansen’s disease affects facial muscles. By using surface electromyography, a system was adapted so as to capture the signals from the largest possible number of facial muscles. We have first looked upon the literature to learn about the way researchers around the globe have been working with diseases that affect the peripheral neural system and how electromyography has acted to contribute to the understanding of these diseases. From these data, a protocol was proposed to collect facial surface electromyographic (sEMG) signals so that these signals presented a high signal to noise ratio. After collecting the signals, we looked for a method that would enable the visualization of this information in a way to make it possible to guarantee that the method used presented satisfactory results. After identifying the method's efficiency, we tried to understand which information could be extracted from the electromyographic signal representing the collected data. Once studies demonstrating which information could contribute to a better understanding of this pathology were not to be found in literature, parameters of amplitude, frequency and entropy were extracted from the signal and a feature selection was made in order to look for the features that better distinguish a healthy individual from a pathological one. After, we tried to identify the classifier that best discriminates distinct individuals from different groups, and also the set of parameters of this classifier that would bring the best outcome. It was identified that the protocol proposed in this study and the adaptation with disposable electrodes available in market proved their effectiveness and capability of being used in different studies whose intention is to collect data from facial electromyography. The feature selection algorithm also showed that not all of the features extracted from the signal are significant for data classification, with some more relevant than others. The classifier Support Vector Machine (SVM) proved itself efficient when the adequate Kernel function was used with the muscle from which information was to be extracted. Each investigated muscle presented different results when the classifier used linear, radial and polynomial kernel functions. Even though we have focused on Hansen’s disease, the method applied here can be used to study facial electromyography in other pathologies.

Unmasking of the trigemino-accessory reflex in accessory facial anastomosis

To evaluate the possible blink reflex responses in facial muscles reinnervated by the accessory nerve. Method: Eleven patients with a complete facial palsy were submitted to a surgical repair by an accessory facial nerve anastomosis (AFA). In this pathological group, blink reflex was studied by means of percutaneous electrical stimulation of the supraorbital nerve and recording from the orbicularis oculi muscle. A control group comprised seven normal people and seven patients with a complete Bell's facial palsy; in this group, responses on the sternocleidomastoideus (SCM) muscles were studied after supraorbital nerve stimulation. Results: All the patients with AFA showed a consistent degree of facial reinnervation. Ten out of the 11 patients with AFA showed reflex responses; in six, responses were configured by a double component pattern, resembling the R1 and R2 components of the blink reflex; three patients had an R1-like response and one patient showed a unique R2 component. Mean values of latencies were 15.2 (SD 4.6) ms for the R1 and 85.3 (SD 9.6) ms for the R2. In the control group, eight out of 14 people had evidence of reflex responses in the SCM muscles; these were almost exclusively configured by a bilateral late component (mean latency 63.5 (SD 15.9) ms) and only one of the subjects showed an early response at 11 ms. Conclusion: The trigemino-accessory reflex response in the pathological group was more complex and of a significantly higher incidence than in the control group. These differences could be tentatively explained by a mechanism of synaptic plasticity induced by the impairment of the efferent portion of the reflex. This could unmask the central linking between the trigeminal and the accessory limbs of the reflex. The findings described could be a demonstration of neurobionomic function in the repairing process of the nervous system.

La retroalimentación facial y su efecto en la evaluación de publicidad de humor

La hipótesis de retroalimentación facial planteada por Tomkins en 1962 sustenta que la activación de algunos músculos faciales envía información sensorial al cerebro y se induce entonces una experiencia emocional en el sujeto. Partiendo de dicha teoría y de investigaciones que la sustentan, el presente estudio se propuso confirmar el efecto de la emoción inducida a través de la retroalimentación facial sobre la evaluación de cinco tipos de humor en publicidad. Para ello se realizó un experimento con 60 hombres y 60 mujeres, que fueron asignados aleatoriamente a una de dos condiciones: estimulación de sonrisa –músculos hacia arriba- o inhibición de sonrisa –músculos hacía abajo-, mientras evaluaban 16 imágenes de publicidad de humor. A partir del análisis de los resultados se encontraron diferencias significativas entre las condiciones; en línea con la hipótesis formulada, los participantes expuestos a la condición estimulación de sonrisa –músculos hacía arriba- evaluaron más positivamente los comerciales. También se encontraron diferencias significativas en función del sexo y los tipos de humor evaluados. El estudio ofrece evidencia empírica de la teoría propuesta hace más de medio siglo y su efecto en el ámbito de la publicidad actual.

Electromyographic analysis of superior belly of the omohyoid muscle and anterior belly of the digastric muscle in mandibular movements

The superior belly of the omohyoid muscle and the anterior belly of the digastric muscle, were studied electromyographically in 20 young volunteers. For each muscle, 1 pair of monopolar electrodes was employed. One was a surface electrode and the other a needle electrode, which was inserted in the belly of the muscle. The surface electrode was placed 1 cm apart from the needle electrode. The most marked action of both muscles was on the movement of lowering the mandible. They also act in those movements for the performance of which they have associated a component of lowering the jaw, propulsion, laterality to the right and the left and retrusion. They are not active in the resting position and during jaw movements of elevation, extrusion and protrusion. Both muscles are active most of the time, simultaneously, but it is not possible to demonstrate that there is a synchronism between their actions.

External location of the buccinator muscle to facilitate electromyographic analysis

Electromyography is frequently used to measure the activity of masticatory muscles. It requires the precise setting of the electrodes, which demands the accurate location of the muscle to be evaluated. The purpose of this study was to investigate the accuracy of an external method to locate the buccinator muscle. Fifteen human cadavers were evaluated and planes were etermined on the face using anatomic landmarks. An angle (α) was obtained at the intersection of these planes on the central point of buccinator muscle and measured with a protractor. The value of the angle allows locating the central point of buccinator muscle based on anatomic landmarks on the face. Statistical analysis of the collected data indicated an angle of 90° with 95% reliability, thus proving the efficacy of the proposed method.

Electromyographic evaluation of the upper lip according to the breathing mode: A longitudinal study

The present study aimed at analyzing and comparing longitudinally the EMG (electromyographic activity) of the superior orbicularis oris muscle according to the breathing mode. The sample, 38 adolescents with Angle Class II Division 1 malocclusion with predominantly nose (PNB) or mouth (PMB) breathing, was evaluated at two different periods, with a two-year interval between them. For that purpose, a 16-channel electromyography machine was employed, which was properly calibrated in a PC equipped with an analogue-digital converter, with utilization of surface, passive and bipolar electrodes. The RMS data (root mean square) were collected at rest and in 12 movements and normalized according to time and amplitude, by the peak value of EMG, in order to allow comparisons between subjects and between periods. Comparison of the muscle function of PNB and PMB subjects at period 1 (P1), period 2 (P2) and the variation between periods (Δ) did not reveal statistically significant differences between groups (p < 0.05). However, longitudinal evaluation of the muscle function in PNB and PMB subjects demonstrated different evolutions in the percentage of required EMG for accomplishment of the movements investigated. It was possible to conclude that there are differences in the percentage of electric activity of the upper lip with the growth of the subjects according to the breathing mode.

Trigeminal neuralgia: Literature review

The trigeminal nerve, fifth equal of cranial nerves, a mixed nerve is considered by possessing motor and sensitive components. The sensitive portion takes to the Nervous System Central somesthesics information from the skin and mucous membrane of great area of the face, being responsible also for a neural disease, known as the Trigeminal Neuralgia. The aim of this study was to review the literature on the main characteristics of Trigeminal Neuralgia, the relevant aspects for the diagnosis and treatment options for this pathology. This neuralgia is characterized by hard pains and sudden, similar to electric discharges, with duration between a few seconds to two minutes, in the trigeminal nerve sensorial distribution. The pain is unchained by light touches in specific points in the skin of the face or for movements of the facial muscles, it can be caused by traumatic sequels or physiologic processes degenerative associate the vascular compression. Prevails in the senior population, frequently in the woman. In a unilateral way it attacks more the maxillary and mandibular divisions, rarely happens in a simultaneous way in the three branches of trigeminal nerve three branches.

Avaliação eletromiográfica dos músculos masseter, temporal e bucinador de lactentes em situação de aleitamento natural e artificial

Pós-graduação em Pediatria - FMB

Descrição do aparelho VABB (Vertically Activated Bite Block) para o tratamento da mordida aberta anterior

Nowadays, the correction of skeletal vertical dysplasia is considered a great challenge in Orthodontics. The skeletal open bite treatment presents limitations related to vertical growth pattern, the extension of open bite and especially the stability, which is very questioned. The treatment of skeletal open bite is mostly realized by the inhibition of vertical alveolar posterior development (relative intrusion) or absolute intrusion of posterior teeth, through vertical forces, generated by the action of masticatory muscles. The purpose of this article is to present a new appliance for the treatment of skeletal open bite, the VABB (Vertically Activated Bite Block) or modified Bite Block, whose action mechanism is to limit the vertical development of the molars, by the action of facial muscles and two bilateral expansion screws that provide a counterclockwise rotation of the mandible. It will also be presented a clinical case and the technical steps for the construction of this appliance.