Bianchi Bernardo, Ferri Andrea, Sesenna Enrico
Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy.
Curr Opin Otolaryngol Head Neck Surg. 2012 Apr;20(2):114-9. doi: 10.1097/MOO.0b013e32834fa744.
This article reviews literature on the facial reanimation technique, from direct facial nerve repair and grafting to neuromuscular-free transplantation. The discussion will focus on the indications of the different approaches based on timing of the facial palsy and on patient's features.
Facial nerve coaptation technique with masseteric nerve, babysitter procedures, and neuromuscular transplantation represent today the gold standard for facial reanimation after facial nerve sacrifice. Surgeon's experience and patient selection have to be considered as other important factors for surgical approach selection.
Facial animation represents a difficult challenge for the reconstructive surgeon. A large number of surgical techniques and modifications have been published, and the appropriate approach must be selected based on the kind of facial palsy, its timing, and the patient's age, prognosis, and general condition. A complete grasp of all the approaches that allows for a target surgery represents today an essential assumption for the facial reanimation.
本文回顾了从直接面神经修复与移植到无神经肌肉移植的面部重建技术相关文献。讨论将聚焦于基于面瘫发生时间和患者特征的不同方法的适应证。
咬肌神经面神经吻合技术、保姆手术和神经肌肉移植是目前面神经牺牲后面部重建的金标准。外科医生的经验和患者选择是手术方法选择的其他重要因素。
面部动态重建是重建外科医生面临的一项艰巨挑战。已经发表了大量的手术技术和改良方法，必须根据面瘫的类型、发生时间以及患者的年龄、预后和一般状况选择合适的方法。全面掌握所有可供选择的手术方法是目前面部重建的基本前提。
