Wax Mark K, Kaylie David M
Department of Otolaryngology/Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA.
Head Neck. 2007 Jun;29(6):546-9. doi: 10.1002/hed.20562.
We sought to determine the effect of positive neural margins on subsequent facial nerve function following facial nerve grafting.
In this retrospective review, 19 patients had sacrifice of their facial nerve with immediate facial nerve grafting, 8 had positive neural margins, and 11 had negative neural margins. Facial nerve function was analyzed using the House-Brackman scale.
In the first group (8 patients), 5 had positive proximal margins and 3 had positive distal neural margins. Outcome by House-Brackman score was III (2 patients), IV (3 patients), V (1 patient), and VI (2 patients). In the second group (no evidence of neural spread, 11 patients), outcome was III (3 patients), IV (2 patients), V (2 patients), and VI (4 patients).
No significant difference in the outcome of facial nerve function was seen between these 2 groups. Facial nerve grafting should be considered in patients whose facial nerve is sacrificed, even when there is evidence of tumor in the perineurium at the margin of resection.
我们试图确定面神经移植术后神经切缘阳性对后续面神经功能的影响。
在这项回顾性研究中，19例患者接受了面神经牺牲并立即进行面神经移植，其中8例神经切缘阳性，11例神经切缘阴性。使用House-Brackman量表分析面神经功能。
在第一组（8例患者）中，5例近端切缘阳性，3例远端神经切缘阳性。根据House-Brackman评分，结果为Ⅲ级（2例患者）、Ⅳ级（3例患者）、Ⅴ级（1例患者）和Ⅵ级（2例患者）。在第二组（无神经扩散证据，11例患者）中，结果为Ⅲ级（3例患者）、Ⅳ级（2例患者）、Ⅴ级（2例患者）和Ⅵ级（4例患者）。
这两组之间面神经功能结果无显著差异。即使在切除边缘的神经束膜中有肿瘤证据，对于面神经已牺牲的患者也应考虑进行面神经移植。
