Campero Alvaro, Ajler Pablo, Socolovsky Mariano, Martins Carolina, Rhoton Albert
Departmento de Neurocirugía, Universidad de Florida, Gainesville, Florida, USA ; Departamento de Anatomía, Facultad de Medicina, Universidad de Tucumán, Tucumán, Argentina.
Surg Neurol Int. 2012 Dec 8;3(Suppl 6):S400-4. doi: 10.4103/2152-7806.104405. Print 2012.
Hypoglossal-facial anastomosis is the gold standard treatment for facial reanimation in those cases where the facial nerve has been damaged near the brainstem. The technique that requires temporal bone drilling and partial section of the hypoglossal nerve is usually preferred. This technique diminishes tongue morbidity while preserves good facial reanimation. The goal of the present work is to describe a simple technique to expose the mastoid portion of the facial nerve.
The mastoid portion of the facial nerve runs on the anterior wall of the mastoid process; mean 18+/-3 mm deeply to the lateral wall. The supramastoid crest has to be identified; a parallel line is marked from the crest to the mastoid tip, and bone drilling is performed anterior to the line. Once the facial nerve is identified, proximal and distal dissection is performed.
This limited approach allows to a safe exposure of the mastoid segment of the facial nerve. This procedure is technically less demanding but should be restricted to hypoglossal-facial anastomosis.
Surgeons not fully experienced in temporal bone drilling can do this simple approach after performing some laboratory practice.
对于面神经在脑干附近受损的病例，舌下-面神经吻合术是面部功能重建的金标准治疗方法。通常更倾向于采用需要进行颞骨钻孔和舌下神经部分切断的技术。该技术在保留良好面部功能重建的同时，可降低舌部并发症的发生率。本研究的目的是描述一种暴露面神经乳突段的简单技术。
面神经乳突段走行于乳突前壁，平均位于外侧壁深面18±3mm处。必须识别出乳突上嵴；从该嵴向乳突尖标记一条平行线，并在该线前方进行骨钻孔。一旦识别出面神经，即可进行近端和远端解剖。
这种有限的方法能够安全地暴露面神经的乳突段。该手术在技术上要求较低，但应仅限于舌下-面神经吻合术。
在进行一些实验室练习后，未完全熟练掌握颞骨钻孔技术的外科医生也可采用这种简单的方法。
