Pialoux P, Jost G, Freyss G, Rey A, Cophignon J
Ann Otolaryngol Chir Cervicofac. 1976 Jul-Aug;93(7-8):471-86.
The authors describe the technique used in 12 surgical cases of heterolateral facio-facial anastomosis by nerve autograft in the treatment of permanent peripheral facial paralyses. Their main contention is that section of 50 p. 100 of the neurones of the peripheral branches of the facial nerve on the unaffected side does not impair motricity to any extent and that it therefore is possible to anastomose the proximal portion of some healthy branches to the corresponding distal portion of the affected side by placing between them a graft from the external saphenous nerve. The principles for fascicular suture as defined by Seddon and later by Millesi are followed. The technique differs from that made popular by Smith and later by Smii inasmuch as: --the bilateral, hidden face-lift incision makes possible a final passive musculotegumentary suspension of the paralysed side immediately improving the patient's appearance while the nerve re-establishes itself; --retrograde interfascicular dissection on the paralysed side allows precious centimetres to be gained; --pinpointing of the nerve suture area is possible by the placing of a silicone-coated ring with a clip some distance away.
作者描述了在12例采用自体神经移植进行异侧面-面吻合术治疗永久性周围性面瘫的手术病例中所使用的技术。他们的主要观点是，切断患侧面部神经周围分支50%的神经元不会在任何程度上损害运动功能，因此通过在其间放置来自隐神经的移植物，有可能将一些健康分支的近端部分与患侧相应的远端部分进行吻合。遵循了由Seddon以及后来由Millesi所定义的束膜缝合原则。该技术与由Smith以及后来由Smii推广的技术不同之处在于：——双侧隐蔽的面部提升切口使得在神经重建过程中能够对瘫痪侧进行最终的被动肌肉-皮肤悬吊，从而立即改善患者的外观；——在瘫痪侧进行逆行束间解剖可获得宝贵的几厘米长度；——通过在一定距离处放置带有夹子的硅胶涂层环，可以精确确定神经缝合区域。
