Ebersold M J, Quast L M
Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.
J Neurosurg. 1992 Jul;77(1):51-4. doi: 10.3171/jns.1992.77.1.0051.
A number of methods have been developed to reduce the cosmetic and functional disability resulting from facial nerve loss. It has often been suggested that the major trunk of the spinal accessory nerve should not be sacrificed for providing dynamic facial function because of shoulder disability and pain. A review of Mayo Clinic records has revealed that, between the years of 1975 and 1983, 25 patients underwent spinal accessory nerve-facial nerve anastomosis using the major division (branch to the trapezius muscle) of the spinal accessory nerve. There were 11 males and 14 females, ranging in age from 16 to 60 years (mean 41 years). The interval between facial nerve loss and anastomosis was 1 week to 34 months (mean 4.62 months). The duration of follow-up study ranged from 7 to 15 years (mean 10.8 years). Twenty patients had no complaints or symptoms related to their shoulder or arm at the time of this review and no patient had significant shoulder morbidity. The facial function achieved was "minimal" in five cases, "moderate" in six, and good to excellent in 14. Most patients appeared to benefit significantly from the spinal accessory nerve-facial nerve anastomosis. The morbidity of the procedure seemed quite minimal even in the young and active. The authors continue to believe that the spinal accessory nerve-facial nerve anastomosis, even when using the major trunk of the spinal accessory nerve, is a very useful and beneficial procedure.
已经开发出多种方法来减少因面神经损伤导致的外观和功能障碍。人们常常认为，不应为了提供面部动态功能而牺牲副神经主干，因为这会导致肩部残疾和疼痛。对梅奥诊所记录的回顾显示，在1975年至1983年期间，25例患者使用副神经的主要分支（支配斜方肌的分支）进行了副神经-面神经吻合术。其中男性11例，女性14例，年龄在16岁至60岁之间（平均41岁）。面神经损伤与吻合术之间的间隔为1周至34个月（平均4.62个月）。随访研究的持续时间为7年至15年（平均10.8年）。在本次回顾时，20例患者没有与肩部或手臂相关的不适或症状，没有患者出现明显的肩部并发症。面部功能达到“最小”的有5例，“中等”的有6例，“良好”至“优秀”的有14例。大多数患者似乎从副神经-面神经吻合术中受益匪浅。即使在年轻且活跃的患者中，该手术的并发症似乎也相当少。作者仍然认为，副神经-面神经吻合术，即使使用副神经主干，也是一种非常有用且有益的手术。
