Selective Facial Muscle Activation with Acute and Chronic Multichannel Cuff Electrode Implantation in a Feline Model. (April 2022)

• Record Type: Journal Article
• Authors: Sahyouni, Ronald; Goshtasbi, Khodayar; Presacco, Alessandro; Birkenbeuel, Jack; Cheung, Dillon; Abiri, Arash; Berger, Michael H.; Djalilian, Hamid R.; Lin, Harrison W.
• Is Part Of: Annals of otology, rhinology & laryngology. Volume 131:Number 4(2022)
• Page Start: 365
• Page End: 372
• Publication Date: 2022-04
• Subjects: facial nerve -- neuroprosthetic -- facial paralysis -- cuff electrode -- EMG; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/00034894211023218
• Languages: English
• ISSNs: 0003-4894

Abstract

Objectives: Facial paralysis is a debilitating condition with substantial functional and psychological consequences. This feline-model study evaluates whether facial muscles can be selectively activated in acute and chronic implantation of 16-channel multichannel cuff electrodes (MCE). Methods: Two cats underwent acute terminal MCE implantation experiments, 2 underwent chronic MCE implantation in uninjured facial nerves (FN) and tested for 6 months, and 2 underwent chronic MCE implantation experiments after FN transection injury and tested for 3 months. The MCE were wrapped around the main trunk of the skeletonized FN, and data collection consisted of EMG thresholds, amplitudes, and selectivity of muscle activation. Results: In acute experimentation, activation of specific channels (ie, channels 1-3 and 6-8) resulted in selective activation of orbicularis oculi, whereas activation of other channels (ie, channels 4, 5, or 8) led to selective activation of levator auris longus with higher EMG amplitudes. MCE implantation yielded stable and selective facial muscle activation EMG thresholds and amplitudes up to a 5-month period. Modest selective muscle activation was furthermore obtained after a complete transection-reapproximating nerve injury after a 3-month recovery period and implantation reoperation. Chronic implantation of MCE did not lead to fibrosis on histology. Field steering was achieved to activate distinct facial muscles by sending simultaneous subthreshold currents to multiple channels, thus theoretically protecting against nerve damage from chronic electrical stimulation. Conclusion: Our proof-of-concept results show the ability of an MCE, supplemented with field steering, to provide a degree of selective facial muscle stimulation in a feline model, even following nerve regeneration after FN injury. Level of evidence: N/A