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
Processing time: 246 Days and 5.9 Hours
ARTICLE HIGHLIGHTS
Research background

Functional epiphora is a clinical condition which is not due to an anatomic defect, and the exact causes of epiphora remain unclear. In this study, we used electromyography (EMG) to evaluate the orbicularis oculi muscle, and the results suggested neurogenic muscle motor neuron disease in functional epiphora patients.

Research motivation

Most studies agree that functional epiphora involves the action of the orbicularis oculi muscle, particularly its deeper segment (Horner’s muscle), but the exact mechanism is not clear. In this study, we used EMG to evaluate Horner’s muscle and its relation to functional epiphora, which may provide a new way to evaluate orbicularis oculi muscle-related disease.

Research objectives

The objective of this study was to evaluate the orbicularis oculi muscle in functional epiphora patients using EMG. The data indicated the presence of neurogenic orbicularis oculi muscle damage in epiphora patients, which might be the cause of functional epiphora.

Research methods

Three groups were included in this study: Functional epiphora, normal controls and facial palsy patients who served as positive controls. Quantitative EMG was performed in the deeper segment of the orbicularis oculi muscle. The average duration of each EMG waveform was measured. A one-way ANOVA was used to compare the average duration of the EMG waveform in the three groups. A P value ≤ 0.05 was considered statistically significant.

Research results

The duration of EMG waveforms in the functional epiphora group and facial palsy group were significantly longer than those in the normal control group (P < 0.05), indicating the presence of neurological damage in functional epiphora patients. The small number of patients included in the study and the lack of a control group for analysis of treatment decision specificity, require further investigation.

Research conclusions

The cause of functional epiphora is not clear; however, orbicularis oculi muscle weakness might be related to functional epiphora. To determine the etiology of muscle weakness in functional epiphora, we used EMG to evaluate the orbicularis oculi muscle, in order to provide an approach for the diagnosis of functional epiphora. EMG was a valuable tool in evaluating the orbicularis oculi muscle, and the results suggest the presence of neurogenic muscle motor neuron disease in functional epiphora patients, which might help us to treat functional epiphora in another way.

Research perspectives

EMG of the orbicularis oculi muscle is a valuable tool for identifying treatment approaches for functional epiphora. The etiology of neurogenic damage in the orbicularis oculi muscle requires further investigation.