Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2020; 8(14): 3000-3005
Published online Jul 26, 2020. doi: 10.12998/wjcc.v8.i14.3000
Diagnostic value of orbicularis oculi muscle electromyography in functional epiphora
Hui Lu, Pei-Dong Liu, Xue Yao, Zuo-Fen Wang, Li-Fen Gao, Shao-Peng Wang
Hui Lu, Xue Yao, Zuo-Fen Wang, Li-Fen Gao, Shao-Peng Wang, Department of Ophthalmology, Zibo Central Hospital, Zibo 255000, Shandong Province, China
Pei-Dong Liu, Department of Electromyography, Zibo Central Hospital, Zibo 255000, Shandong Province, China
Author contributions: Lu H wrote the manuscript; Liu PD and Yao X were the patient’s operators; Wang ZF and Gao LF reviewed the literature and contributed to manuscript drafting; Wang SP was responsible for revision of the manuscript for important intellectual content and contributed to diagnosis; all authors issued final approval for the version to be submitted.
Institutional review board statement: This study was reviewed and approved by the Science and Research Office of Zibo Central Hospital.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement checklist of items, and the manuscript was prepared and revised according to the STROBE Statement checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Shao-Peng Wang, MD, Doctor, Department of Ophthalmology, Zibo Central Hospital, No. 54, Gongqingtuanxi Road, Zhangdian District, Zibo 255000, Shandong Province, China. 904268100@qq.com
Received: November 21, 2019
Peer-review started: February 25, 2019
First decision: April 8, 2020
Revised: May 12, 2020
Accepted: June 20, 2020
Article in press: June 20, 2020
Published online: July 26, 2020
Abstract
BACKGROUND

Functional epiphora is a clinical condition which is not due to an anatomic defect. Most studies agree that it involves the action of the orbicularis oculi muscle, particularly its deeper segment (Horner’s muscle), but the exact mechanism is not clear.

AIM

To evaluate the orbicularis oculi muscle in functional epiphora patients using electromyography (EMG).

METHODS

A total of 8 Chinese patients (16 eyes) with functional epiphora were enrolled in this study, and ten volunteers (10 eyes) were included as normal controls. Five epiphora patients (five eyes) with facial palsy served as positive controls. Quantitative EMG was performed in the deeper segment of orbicularis oculi muscle. The average duration of each EMG waveform was measured.

RESULTS

The average duration of EMG waveforms in the normal control group, the functional epiphora group, and the facial palsy group were 6.39 ± 0.73 ms, 9.39 ± 1.32 ms and 11.2 ± 1.42 ms, respectively. The duration of EMG waveforms was significantly longer in the functional epiphora group than in the normal control group (P < 0.05), and shorter than that in the facial palsy group (P < 0.05).

CONCLUSION

These data indicate the presence of neurogenic orbicularis oculi muscle damage in epiphora patients, which may be the cause of functional epiphora. The etiology of neurogenic damage in the orbicularis oculi muscle requires further investigation.

Keywords: Functional epiphora, Electromyography, Orbicularis oculi muscle, Neurological damage, Etiology, Treatment

Core tip: Functional epiphora is a clinical condition which is not due to an anatomic defect, and the cause of functional epiphora is not very clear. In this study, we used electromyography as a valuable tool to evaluate the orbicularis oculi muscle, and the results suggest neurogenic muscle motor neuron disease in functional epiphora patients. This study reveals a possible new approach for the treatment of functional epiphora.