title: Restoration of eye closure in facial paralysis using implantable electromagnetic actuator.
abstract: The most devastating outcome of facial nerve paralysis is the inability to completely close the eye as it can lead to corneal ulceration and loss of vision. Gravity-assisted eye closure with upper lid loading is commonly used; however it is limited in replicating physiological eye closure to adequately lubricate the cornea. Superior results can be obtained using more advanced reconstructive approaches, however they depend on nerve regrowth which may be unpredictable and prolonged. This report describes a novel technique for creating an active eye closure using an implantable actuator. A generated magnetic field creates lateral movement in an electromagnet that is translated to the eyelid through a sling design. The device is powered wirelessly through a transcutaneous induction link and can be hermetically encapsulated for patient safety. The initial phase of device development is presented including data of a fully functioning prototype and the results of its application in animal and human cadavers.
authors.affiliation: South Western Clinical School, UNSW, Sydney, Australia. Electronic address: sha.has@hotmail.com.
authors.forename: Shaheen
authors.initials: S
authors.lastname: Hasmat
authors.affiliation: Graduate School of Bioengineering, UNSW, Sydney, Australia.
authors.forename: Nigel H
authors.initials: NH
authors.lastname: Lovell
authors.affiliation: Graduate School of Bioengineering, UNSW, Sydney, Australia.
authors.forename: Gregg J
authors.initials: GJ
authors.lastname: Suaning
authors.affiliation: Central Clinical School, University of Sydney, Sydney, Australia; Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Australia.
authors.forename: Tsu-Hui Hubert
authors.initials: TH
authors.lastname: Low
authors.affiliation: South Western Clinical School, UNSW, Sydney, Australia; Central Clinical School, University of Sydney, Sydney, Australia; Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Clark
mesh_terms: D002102:Cadaver; D055590:Electromagnetic Phenomena; D005143:Eyelids / Q000601:surgery*; D005158:Facial Paralysis / Q000601:surgery*; D006801:Humans; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures; D014159:Transducers
keywords: Electromagnetic actuator; Eyelid; Facial nerve paralysis; Lagophthalmos; Lid loading; Temporalis muscle transposition