A blinking periorbital prosthesis using surface electromyographic
signals of the orbicularis oculi muscle
Tadashi Akamats u
Received: 27 March 2015 /Accepted: 12 May 2015 /Published online: 3 June 2015
The Author(s) 2015. This article is published with open access at Springerlink.com
Background Recent advances in human–machine interface
technology have enabled the development of multifunctional,
primarily orthopedic myoelectric prostheses. We developed a
noninvasive blinking periorbital prosthesis that can synchro-
nize with blinking of the intact eyelid by using surface elec-
tromyographic signals of the orbicularis oculi muscle.
Methods Myoelectric potentials of the orbicularis oculi mus-
cle while blinking were measured with surface electrodes on
the eyelid in four healthy adults. Possible cross talk introduced
via the electrodes was also measured and assessed to deter-
mine whether cross talk would affect surface electromyo-
graphic measurements while blinking.
Results The amplitude of the surface myoelectric potential of
the orbicularis oculi muscle was sufficiently high for the prac-
tical use of blinking prostheses. Our blinking model was suc-
cessfully synchronized with blinks of the subjects’ eyelids
under experimental conditions without cross talk between
the orbicularis oculi muscle and other muscles.
Conclusions Although our study revealed several problems,
the use of surface electromyographic signals could be a prom-
ising and useful technique for synchronizing blinking of the
prosthetic eyelid with blinking of the intact eyelid.
Level of Evidence: Level V, therapeutic study.
Recent advances in human–machine interface technology have
enabled the development of multifunctional myoelectric pros-
theses as reported mainly in the orthopedic field [1–4]. In the
cranio-maxillofacial surgery field, reconstructive treatment with
silicon facial prostheses is still indicated in some patients with
large periorbital tissue defects [5–7]. Several researchers have
developed orbital prostheses with eyelid movements to improve
the unnatural appearance of the prosthesis [8, 9].
We have been developing a blinking periorbital prosthesis
that can be synchronized with blinking of the intact eyelid
using electromyographic (EMG) signals detected noninva-
sively from the skin surface above the orbicularis oculi mus-
cle. Various human–machine interface technologies exist to
detect the patient’s movement intention. Such technologies
typically use EMG signals, electroencephalographic (EEG)
signals through scalp or intracranial electrodes [10, 11], or a
combination of these systems . Among these signals, sur-
face EMG signals are used in most prosthetic limbs that are
already in practical use in the orthopedic field . Therefore,
we consider surface EMG signals to be the most promising
approach to develop blinking maxillofacial prostheses that can
be used by patients in real-life conditions.
Electronic supplementary material The online version of this article
(doi:10.1007/s00238-015-1111-4) contains supplementary material,
which is available to authorized users.
* Tadashi Akamatsu
Department of Plastic and Reconstructive Surgery, School of
Medicine, Tokai University, 143 Shimokasuya, Isehara,
International Institute for Science and Education, International
Pacific University, 1-1-7 Sakuragicho, Yokohama, Kanagawa, Japan
Ahead Laboratories Inc., 1-2-14 Shinkawa, Chuo, Tokyo, Japan
Eur J Plast Surg (2015) 38:371–376