Cleveland, Ohio From the Dermatology and Plastic Surgery Institute, Cleveland Clinic.
Plast Reconstr Surg. 2011 Feb;127(2):652-662. doi: 10.1097/PRS.0b013e3181fed6fd.
The human face is a highly specialized organ for receiving the sensory information from the environment and for its transmission to the cortex. The advent of facial transplantation has shown that excellent reconstruction of disfiguring defects can be achieved; thus, the expectations are now focused on functional recovery of the transplant. So far, restoration of facial sensation has not received the same attention as the recovery of motor function.
A thorough review of the literature was performed to investigate the current knowledge on the sensory pathways of the human face and their functions to evaluate current methods of sensory assessment and the available data on normal sensation.
The presence of Meissner and Ruffini corpuscles, Merkel disks, hair-associated fibers, and intraepidermal free nerve endings was confirmed. Occurrence of extensive cross-communications between trigeminal and facial nerve was substantiated. Two-point discrimination and pressure thresholds represented the most objective measures of facial sensation. Age, sex, and smoker status of the patients were shown to influence normal sensibility values. The most suitable areas for sensory testing based on the tested modality and innervation were inferred. The anatomical course of the nerves and their variations had implications for the harvest of face allografts and repair of the sensory nerves.
This review has illustrated the complexity of sensory pathways of the face and their influence on somatic and visceral responses. In view of the discussed data, during facial transplantation, it is important to consider different mechanisms of restoration of facial sensation.
面部是一个高度专业化的器官，用于接收来自环境的感觉信息，并将其传输到大脑皮层。面部移植的出现表明，可以实现对毁容性缺陷的出色重建；因此，现在的期望集中在移植的功能恢复上。到目前为止，面部感觉的恢复并没有像运动功能的恢复那样受到同样的重视。
对文献进行了全面回顾，以调查人类面部感觉通路及其功能的现有知识，评估当前的感觉评估方法和正常感觉的现有数据。
证实了 Meissner 和 Ruffini 小体、Merkel 盘、毛发相关纤维和表皮内游离神经末梢的存在。证实了三叉神经和面神经之间存在广泛的交叉通讯。两点辨别和压力阈值是面部感觉最客观的测量方法。患者的年龄、性别和吸烟状况被证明会影响正常感觉值。根据所测试的模式和神经支配，推断出最适合感觉测试的区域。神经的解剖路径及其变化对异体面部移植物的采集和感觉神经的修复有影响。
本综述说明了面部感觉通路的复杂性及其对躯体和内脏反应的影响。鉴于所讨论的数据，在面部移植过程中，考虑到面部感觉恢复的不同机制很重要。
