Original Investigation |

Whisking Recovery After Automated Mechanical Stimulation During Facial Nerve Regeneration

Ingrid J. Kleiss, MD1,3; Christopher J. Knox, BS1; Juan S. Malo, MD1; Henri A. M. Marres, MD, PhD3; Tessa A. Hadlock, MD1; James T. Heaton, PhD2
[+] Author Affiliations
1Department of Otolaryngology/Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston
2Department of Surgery, Massachusetts General Hospital, Boston
3Department of Otorhinolaryngology/Head and Neck Surgery, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
JAMA Facial Plast Surg. 2014;16(2):133-139. doi:10.1001/jamafacial.2013.2217.
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Importance  Recovery from facial nerve transection is typically poor, but daily mechanical stimulation of the face in rats has been reported to remarkably enhance functional recovery after facial nerve transection and suture repair. This phenomenon needs additional investigation because of its important clinical implications.

Objective  To determine whether automated mechanical stimulation of the whisker pad improves whisking recovery after facial nerve transection and repair in a rat model.

Design and Setting  Sixty-one rats underwent unilateral facial nerve transection and suture repair and were randomized into 8 groups. Six groups received daily automated whisker or whisker pad mechanical stimulation including 0.5-, 1.5-, and 8.0-Hz patterns. Two control groups received restraint without stimulation. Treatment started on postoperative day 8, occurred 5 days per week, and lasted throughout 15 weeks of recovery. Whisking amplitude, velocity, and acceleration were quantified weekly for 15 weeks.

Interventions  Unilateral facial nerve transection, suture repair, and, for 6 groups, daily automated whisker or whisker pad mechanical stimulation.

Main Outcomes and Measures  Quantification of whisking amplitude, velocity, and acceleration.

Results  Rats receiving the low frequencies of stimulation of the whiskers or whisker pad did not demonstrate enhanced whisking recovery, and rats receiving stimulation at 8.0 Hz showed significantly worse whisking recovery compared with controls and previously published groups receiving lower dose manual stimulation.

Conclusions and Relevance  Although daily manual whisker pad stimulation has been shown to enhance whisking recovery, rats in this study did not demonstrate improved whisking recovery after automated mechanical stimulation across a wide range of driving frequencies. Moreover, faster stimulation (8.0 Hz) was actually detrimental to recovery. Further work is needed to understand the relationship between stimulation patterns and the physiologic mechanisms underlying improved or worsened functional outcomes after facial nerve transection and repair.

Level of Evidence  NA

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Figure 1.
Rat in the Whisk Assist Apparatus

A, System overview. B, The comb in position to drive whisker movement. C, The bristle brush in position to mechanically stimulate the whisker pad.

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Figure 2.
Mean Recovery of Whisking Amplitude Across Weeks 3 to 15 for Experimental and Control (CNTR) Groups

Relative recovery determined as a ratio of whisking amplitude for the nerve-repaired side divided by the healthy side. The different groups are described in the Table. Standard error bars are shown.

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Figure 3.
Recovery of Amplitude for the 8.0-Hz Experimental and Control (CNTR) Groups

A, Columns represent mean relative recovery of amplitude. Standard error bars are shown. B, Columns represent the mean recovery of amplitude across weeks 3 to 15 for the 8.0-Hz experimental groups. Standard error bars are shown.aP < .001.bP = .02.cP = .009.

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Figure 4.
Mean Recovery of Whisking Amplitude Across Weeks 3 to 15 of the Present Study (Combined Groups) and Manual Mechanical Stimulation (MMS)11

All CNTR indicates combination of control A (CNTR-A) and CNTR-B; all 8.0 Hz, combination of the three 8.0-Hz conditions (groups 8.0 Hz–A, Hz–B, and Hz–C). Standard error bars are shown.aP = .001.bP = .004.

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