Department of Otorhinolaryngology, Friedrich-Schiller-University Jena, Germany.
Laryngoscope. 2011 Apr;121(4):699-706. doi: 10.1002/lary.21399. Epub 2011 Feb 1.
OBJECTIVES/HYPOTHESIS: To describe cortical reorganization after classic hypoglossal-facial nerve anastomosis (HFA) (four patients), hypoglossal-facial nerve jump anastomosis (HFJA) (three patients), and facial nerve interpositional graft (FNIG) (three patients).
Prospective case series.
Functional magnetic resonance imaging (fMRI) was performed during lip and tongue movement using a block or an event-related design.
Despite the presence of some intersubject variability, the following general brain activation patterns were revealed: As expected, lip movements after FNIG led to selective brain activation in the original facial motor cortex, and lip movements after HFA were associated with activation in the hypoglossal motor cortex. Following HFJA, lip movements resulted in overlapping activation encompassing both the original facial and the hypoglossal motor cortex, but tongue movements led solely to strong activation within the original hypoglossal motor cortex. In contrast, tongue movements after HFA were associated with strong activation in the original hypoglossal motor cortex and weaker activation in the facial motor cortex.
Direct facial nerve repair (FNIG) leads to restoration of the original cortical activation. A cross nerve suture (HFA or HFJA) changes cortical activation and leads to different patterns of cortical activation during lip and tongue movements.
目的/假设：描述经典舌下神经-面神经吻合术（HFA）（4 例）、舌下神经-面神经跳跃吻合术（HFJA）（3 例）和面神经移植术（FNIG）（3 例）后的皮质重组。
前瞻性病例系列。
使用块或事件相关设计在进行唇舌运动时进行功能磁共振成像（fMRI）。
尽管存在一些个体间的变异性，但揭示了以下一般的大脑激活模式：正如预期的那样，FNIG 后的唇运动导致原始面神经运动皮层的选择性大脑激活，而 HFA 后的唇运动与舌下运动皮层的激活相关。HFJA 后，唇运动导致重叠激活，包括原始面神经和舌下运动皮层，但舌运动仅导致原始舌下运动皮层内的强烈激活。相比之下，HFA 后的舌运动与原始舌下运动皮层的强烈激活和面神经运动皮层的较弱激活相关。
直接面神经修复（FNIG）导致原始皮质激活的恢复。交叉神经缝合（HFA 或 HFJA）改变皮质激活，并导致唇舌运动时不同的皮质激活模式。
