Labbé D, Bénichou L, Iodice A, Giot J-P
Service de chirurgie maxillofaciale, CHU de Caen, avenue Côte-de-Nacre, Caen, France.
Ann Chir Plast Esthet. 2012 Jun;57(3):281-5. doi: 10.1016/j.anplas.2012.02.013. Epub 2012 May 28.
After facial paralysis recovery, it is common to note a co-contraction between depressor anguli oris (DAO) muscle and zygomatic muscles. This DAO co-contraction will "obstruct" the patient's smile. The purpose of this technical note is to show how to find the DAO sign and how to free up the smile. TECHNICAL: This co-contraction between the zygomatic muscles and DAO research is placing a finger on marionette line, asking the patient to smile: we perceive a rope under the skin corresponding to the abnormal contraction and powerful DAO. A diagnostic test with lidocaine injection into the DAO can be performed to confirm the diagnosis. The treatment of pathological DAO's contraction can be by injection of botulinum toxin in the DAO, or by surgical myectomy. In all cases, a speech therapy complete the treatment.
The DAO sign is a semiological entity easy to find. His treatment releases smile without negative effect on the facial expression as the DAO is especially useful in the expression of disgust.
面瘫恢复后,口降肌(DAO)与颧肌之间出现共同收缩是常见现象。这种DAO共同收缩会“阻碍”患者的微笑。本技术说明的目的是展示如何发现DAO体征以及如何释放微笑。技术方法:颧肌与DAO之间的这种共同收缩研究是将手指放在木偶纹上,让患者微笑:我们能感觉到皮下有一条绳索,对应着异常收缩且有力的DAO。可以进行向DAO注射利多卡因的诊断性测试以确诊。病理性DAO收缩的治疗方法可以是向DAO注射肉毒杆菌毒素,或进行手术切除肌肉。在所有情况下,言语治疗可完善治疗。
DAO体征是一种易于发现的症状学实体。其治疗可释放微笑,且对面部表情无负面影响,因为DAO在表达厌恶情绪时特别有用。