Yavuzer R, Jackson I T
Institute for Craniofacial and Reconstructive Surgery, Providence Hospital, Southfield, Mich 48075, USA.
Plast Reconstr Surg. 2001 Dec;108(7):1874-9. doi: 10.1097/00006534-200112000-00005.
Malfunction of the marginal mandibular nerve, either in combination with a generalized facial palsy or in isolation, can cause an unpleasant and disturbing appearance around the mouth. In total palsy, a cross-facial nerve graft combined with a free vascularized muscle transplant will usually deal with this problem successfully; however, all older procedures used in this situation are unpredictable. For the isolated palsy, procedures such as digastric muscle transfer or sling suspension are not uniformly successful. A method using the contralateral, nonaffected lower lip orbicularis muscle is described. A wedge is removed from the paralyzed lower lip and the orbicularis is advanced to the modiolus to provide a functional orbicularis all the way across the lower lip up to the angle of the mouth. This is a simple outpatient procedure that has produced satisfactory results in most cases.
下颌缘支神经功能障碍，无论是合并全身性面瘫还是单独出现，都可能导致口周外观令人不适且有碍观瞻。在完全性面瘫中，面神经交叉移植联合游离带血管肌肉移植通常能成功解决这一问题；然而，在这种情况下使用的所有传统手术都具有不可预测性。对于孤立性面瘫，诸如二腹肌转移或吊带悬吊等手术并非总能成功。本文描述了一种使用对侧未受影响的下唇轮匝肌的方法。从瘫痪的下唇切除一块楔形组织，将轮匝肌推进至蜗轴，以在下唇直至口角全程提供功能性轮匝肌。这是一个简单的门诊手术，在大多数情况下都取得了满意的效果。
