Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Indiana University Health, Indianapolis, USA.
Am J Otolaryngol. 2011 Nov-Dec;32(6):511-6. doi: 10.1016/j.amjoto.2010.09.007. Epub 2010 Nov 20.
Several methods of neural rehabilitation for facial paralysis using 12-7 transfers have been described. The purpose of this study is to report on a series for dynamic reinnervation of the paralyzed face by using a split 12-7 nerve transposition. The goals of this procedure are to minimize tongue morbidity and to provide good facial reinnervation.
Prospective case series. Melolabial crease discursion, overall facial movement, and degree of tongue atrophy and mobility were recorded.
Thirteen patients underwent facial reanimation using a split hypoglossal-facial nerve transfer with postoperative follow-up to 58 months (range, 6-58 months). All patients achieved excellent rest symmetry and facial tone. Of 13 patients, 10 had measurable coordinated movement and discursion of their melolabial crease. Of 13 patients, 12 had mild to moderate ipsilateral tongue atrophy. The mean time to onset of visible reinnervation was 3 months.
Split hypoglossal-facial nerve transposition provides good rehabilitation of facial nerve paralysis with reduced lingual morbidity. Long-term rest symmetry and potential learned movement can be achieved. This technique may provide a favorable alternative to the traditional method of complete hypoglossal sacrifice or jump grafting.
已有多种十二对七神经移位术治疗面瘫的方法被描述。本研究旨在报告一项应用十二对七神经劈裂移位术进行动力性面神经再支配的系列研究。该术式的目标是最小化舌部的发病率,并提供良好的面神经再支配。
前瞻性病例系列研究。记录唇颊沟偏移、整体面部运动、舌萎缩和活动度以及程度。
13 例患者接受了舌下神经-面神经劈裂移植的面部再神经支配,术后随访 58 个月(范围:6-58 个月)。所有患者均获得了极佳的休息时对称性和面部张力。13 例患者中,10 例有可测量的协调运动和唇颊沟的偏移。13 例患者中,12 例同侧舌有轻度到中度萎缩。可见再神经支配的平均起始时间为 3 个月。
舌下神经-面神经劈裂移位术为面神经麻痹提供了良好的康复治疗,减少了舌部发病率。可以实现长期的休息时对称性和潜在的习得性运动。与传统的完全舌下神经牺牲或跳跃移植方法相比,该技术可能是一种有利的替代方法。