Bernat Isabelle, Vitte Elizabeth, Lamas Georges, Soudant Jacques, Willer Jean Claude, Tankéré Frédéric
Department of Otorhinolaryngology, Hôpital Pitié-Salpêtrière, 47 Boulevard de l'Hôpital, 75013 Paris, France.
Muscle Nerve. 2006 Mar;33(3):334-41. doi: 10.1002/mus.20464.
The aim of this work was to determine the role of peripheral facial muscle reinnervation in the central reorganization of the blink reflex (BR) after hypoglossal-facial anastomosis (HFA). An electrophysiological study was performed on seven patients who underwent HFA after facial nerve transection during surgery for acoustic neuroma. HFA was performed within 15 days after surgery in five patients (group 1) and later for the two others (group 2). We studied the motor responses (MR) and the BR evoked on the affected side, before and over 3 years after the HFA. The MR appeared by the third month for the first group, and by the sixth and twelfth for the second group. After 36 months, the amplitude of MR was significantly higher than its control value, showing hyperinnervation of the facial muscles. Study of the BR evoked only an R1-type blink response that was observed 4 and 6 months after the MR for groups 1 and 2, respectively. This central reorganization appeared closely correlated with muscle reinnervation and its related timing. The occurrence of peripheral nerve-muscle contacts seems to be a necessary condition for reorganization of the trigemino-hypoglossal-facial reflex.
这项工作的目的是确定舌下-面神经吻合术（HFA）后周围面部肌肉再支配在眨眼反射（BR）中枢重组中的作用。对7例在听神经瘤手术中面神经横断后接受HFA的患者进行了电生理研究。5例患者（第1组）在术后15天内进行了HFA，另外2例（第2组）则在术后较晚时间进行。我们研究了HFA前及术后3年以上患侧的运动反应（MR）和BR。第1组在第三个月出现MR，第2组在第六个月和第十二个月出现。36个月后，MR的幅度显著高于其对照值，表明面部肌肉存在超神经支配。对BR的研究仅诱发了R1型眨眼反应，第1组和第2组分别在MR出现后4个月和6个月观察到。这种中枢重组似乎与肌肉再支配及其相关时间密切相关。周围神经-肌肉接触的出现似乎是三叉神经-舌下神经-面神经反射重组的必要条件。
