Tate James R, Tollefson Travis T
Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, 95817, USA.
Curr Opin Otolaryngol Head Neck Surg. 2006 Aug;14(4):242-8. doi: 10.1097/01.moo.0000233594.84175.a0.
Facial paralysis often has a significant emotional impact on patients. Along with the myriad of new surgical techniques in managing facial paralysis comes the challenge of selecting the most effective procedure for the patient. This review delineates common surgical techniques and reviews state-of-the-art techniques.
The options for dynamic reanimation of the paralyzed face must be examined in the context of several patient factors, including age, overall health, and patient desires. The best functional results are obtained with direct facial nerve anastomosis and interpositional nerve grafts. In long-standing facial paralysis, temporalis muscle transfer gives a dependable and quick result. Microvascular free tissue transfer is a reliable technique with reanimation potential whose results continue to improve as microsurgical expertise increases. Postoperative results can be improved with ancillary soft tissue procedures, as well as botulinum toxin.
The paper provides an overview of recent advances in facial reanimation, including preoperative assessment, surgical reconstruction options, and postoperative management.
面瘫常常会对患者产生重大的情绪影响。随着面瘫治疗中涌现出大量新的外科技术，为患者选择最有效的治疗方法成为一项挑战。本综述阐述了常见的外科技术，并对最新技术进行了回顾。
对面瘫面部进行动态重建的选择必须综合考虑患者的多个因素，包括年龄、整体健康状况以及患者的期望。直接面神经吻合术和神经移植术能取得最佳的功能效果。对于长期面瘫患者，颞肌转移术能带来可靠且快速的效果。微血管游离组织移植是一种具有重建潜力的可靠技术，随着显微外科技术的提高，其效果也在不断改善。辅助软组织手术以及肉毒杆菌毒素可改善术后效果。
本文概述了面部重建的最新进展，包括术前评估、手术重建方案及术后管理。
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