Henstrom Douglas K, Malo Juan S, Cheney Mack L, Hadlock Tessa A
Facial Nerve Center, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, 243 Charles St., Boston, MA 02114, USA.
Arch Facial Plast Surg. 2011 Jul-Aug;13(4):239-43. doi: 10.1001/archfacial.2011.43.
To describe a procedure to permanently address platysmal synkinesis and hypertonicity and to report changes in quality of life associated with platysmectomy using the Facial Clinimetric Evaluation instrument.
Chemodenervation significantly relieves platysmal synkinesis in almost all patients with significant face and neck synkinesis associated with dynamic facial expressions. We recently began to offer platysmectomy as part of a permanent solution to chronic superficial torticollis-like neck symptoms. For a 10-month period, 24 patients underwent the procedure, and preoperative and postoperative Facial Clinimetric Evaluation data were obtained from 21 patients (88%).
In 19 patients, platysmectomy was performed using local anesthesia without sedation. In the remaining 5 patients, platysmectomy was performed using general anesthesia concurrent with free gracilis transfer for smile reanimation. No intraoperative or postoperative complications occurred. Overall, the patients' quality of life significantly improved after platysmectomy (P = .02).
Platysmectomy is straightforward and seems effective in treating neck synkinesis associated with chronic hypertonic platysmal activity.
描述一种永久性解决颈阔肌联动和高张力的手术方法，并使用面部临床测量评估工具报告与颈阔肌切除术相关的生活质量变化。
化学去神经支配几乎能显著缓解所有因动态面部表情而出现明显面颈部联动的患者的颈阔肌联动。我们最近开始将颈阔肌切除术作为慢性浅表性斜颈样颈部症状的永久性解决方案的一部分。在10个月的时间里，24例患者接受了该手术，术前和术后的面部临床测量评估数据来自21例患者（88%）。
19例患者在未使用镇静剂的局部麻醉下进行了颈阔肌切除术。其余5例患者在全身麻醉下进行颈阔肌切除术，同时进行游离股薄肌转移以恢复笑容。未发生术中或术后并发症。总体而言，颈阔肌切除术后患者的生活质量显著改善（P = .02）。
颈阔肌切除术操作简单，似乎对治疗与慢性高张力颈阔肌活动相关的颈部联动有效。
