title: Restoration of eyelid closure in facial paralysis using artificial muscle: preliminary cadaveric analysis.
abstract: OBJECTIVE
  Electroactive polymer artificial muscle is an emerging technology that has the potential to be used in rehabilitating facial movement in patients with paralysis. These electroactive polymers act like human muscles by expanding and contracting based on variable voltage input levels. The authors seek to establish a reproducible eyelid blink with artificial muscle. The aim of this proof of concept study is to determine whether eyelid closure can be created with a novel eyelid sling model.
  
  
  METHODS
  A human cadaver study was performed.
  
  
  METHODS
  With use of four cadaver heads, an extended upper and lower blepharoplasty incision was used to secure an upper and lower expanded polytetrafluoroethylene implant in the medial orbital wall and tarsal plates. The slings were passed through a hole drilled in the lateral orbital wall or around a titanium screw. Lateral pull on the sling created eyelid closure, and the necessary distance of pull was measured.
  
  
  RESULTS
  The eyelid sling mechanism functioned to achieve complete eyelid closure. Less tension was required for eyelid closure when the sling was placed in both eyelids (3 mm of pull instead of 6 mm).
  
  
  CONCLUSIONS
  The application of artificial muscle to a range of problems that affect both patient morbidity and quality of life is promising. Eyelid closure was created in a cadaver model using a novel sling, but future studies will need to address the feasibility of a prototype artificial muscle eyelid device in humans.
authors.affiliation: Facial Plastic and Reconstructive Surgery, Cleft and Craniofacial Program, Department of Otolaryngology-Head and Neck Surgery, University of California, Davis Medical Center, Davis, CA 95817, USA. travis.tollefson@yahoo.com
authors.forename: Travis T
authors.initials: TT
authors.lastname: Tollefson
authors.forename: Craig W
authors.initials: CW
authors.lastname: Senders
mesh_terms: D001187:Artificial Organs; D040761:Biomimetic Materials; D019882:Blepharoplasty / Q000379:methods*; D002102:Cadaver; D005143:Eyelids / Q000294:innervation / Q000601:surgery*; D005158:Facial Paralysis / Q000601:surgery*; D006801:Humans; D009801:Oculomotor Muscles / Q000601:surgery*; D011138:Polytetrafluoroethylene