Análise de diferentes tarefas para normalização do sinal elétrico do músculo orbicular da boca pela contração voluntária máxima: estudo piloto / Analysis of different tasks to normalize the electrical signal of the orbicularis oris muscle by maximum voluntary contraction: pilot study

RESUMO Objetivo pesquisar a atividade elétrica do músculo orbicular da boca em quatro diferentes tarefas isométricas e indicar a mais apropriada para utilização como referência na normalização do sinal elétrico do músculo orbicular da boca pela contração voluntária máxima. Métodos participaram do estudo 22 indivíduos, sendo dez do sexo masculino e 12 do feminino, com idades entre 20 e 33 anos. A atividade elétrica das porções superior e inferior do músculo orbicular da boca foi registrada durante a realização das seguintes tarefas isométricas: protrusão labial com fechamento, protrusão labial sem fechamento, contrarresistência com a placa de resistência labial e preensão de lábios. A ordem de realização das tarefas foi randomizada entre os participantes. Os dados foram comparados entre as tarefas, para cada seguimento labial. Resultados no segmento marginal superior, a tarefa com maior média e mediana de amplitude foi preensão labial, embora sem diferença significativa entre tarefas. O menor coeficiente de variação foi obtido na tarefa de contrarresistência com a placa de resistência labial. No segmento marginal inferior, a tarefa com maior média e mediana de amplitude foi protrusão labial com fechamento, que também teve o menor coeficiente de variação e diferença significativa entre as tarefas protrusão labial com fechamento e preensão, sendo os maiores valores obtidos na primeira. Conclusão indica-se como referência para a normalização do sinal elétrico do músculo orbicular da boca, pela contração voluntária máxima, a tarefa de protrusão labial com fechamento.

ABSTRACT Purpose To verify the electrical activity of the orbicularis oris in four different isometric tasks and to indicate the most appropriate task for use as a reference in the normalization of the electrical signal of the orbicularis oris muscle by maximum voluntary contraction. Methods Twenty-two individuals participated in the study, of which 10 were male and 12 were female, with ages ranging from 20 to 33 years. The electrical activity of the upper and lower parts of orbicularis oris muscle was recorded during the following isometric tasks: lip protrusion with bilabial closure; lip protrusion without bilabial closure; the counter resistance using the plate of labial resistance and lips prehension. The order of the tasks was randomized among participants. Data were compared between tasks for each lip part. Results in the upper marginal segment, the task with the highest mean and median amplitude was lip prehension, although there was no significant difference between tasks. The lowest coefficient of variation was obtained in the counter resistance task with the plate of labial resistance. In the lower marginal segment, the task with the highest mean and median amplitude was labial protrusion with lips closure, which also had the lowest coefficient of variation. In this segment, there was a significant difference between labial protrusion with lips closure and prehension, with the highest values obtained in the first task. Conclusion lip protrusion with bilabial closure is suggested as reference for the normalization of the electrical signal of the orbicularis oris muscle, by maximum voluntary contraction.

Development of esthetic prosthesis for a patient with severe stigmatizing facial lesions due to cancer: a pilot study.

PURPOSE: Severe physical facial deformities due to surgical interventions can have significant psychosocial consequences to patient's relationships with friends and family and thus, has a considerable impact on their quality of life. We have developed a 3D prosthesis for a 56-year-old woman diagnosed with epidermoid carcinoma at the right hemiface, to improve her quality of life. METHODS: The patient started radiotherapy with modulated intensity. To deal with the advance of the process, a maxilectomy of supra structure with modified radical cervical emptying on the right hemiface was performed. Reconstruction of areas surgically affected by the displacement of islands of skin and muscle (flaps) from healthy regions was initiated. Although the procedure occurred without intercurrences, the patient developed necrosis and loss of the myocutaneous flap. After the removal of the flap, the esthetic result of the treatment was evident causing exposure of subcutaneous and granulation tissues. RESULTS: A computational model was used to develop a 3D structure of the affected area and then used to construct the prosthesis. The prosthesis was applied over the affected area, and the patient was able see her face on the mirror for the first time in years. The patient was grateful and hopeful. CONCLUSION: We have found that the application of this new technology greatly improves the social interaction of patients with deformities due to surgical interventions.