Gordin Eli, Lee Thomas S, Ducic Yadranko, Arnaoutakis Demetri
Department of Otolaryngology-Head and Neck Surgery, SUNY Downstate Medical Center, Brooklyn, New York.
Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia.
Craniomaxillofac Trauma Reconstr. 2015 Mar;8(1):1-13. doi: 10.1055/s-0034-1372522.
The management of facial paralysis continues to evolve. Understanding the facial nerve anatomy and the different methods of evaluating the degree of facial nerve injury are crucial for successful management. When the facial nerve is transected, direct coaptation leads to the best outcome, followed by interpositional nerve grafting. In cases where motor end plates are still intact but a primary repair or graft is not feasible, a nerve transfer should be employed. When complete muscle atrophy has occurred, regional muscle transfer or free flap reconstruction is an option. When dynamic reanimation cannot be undertaken, static procedures offer some benefit. Adjunctive tools such as botulinum toxin injection and biofeedback can be helpful. Several new treatment modalities lie on the horizon which hold potential to alter the current treatment algorithm.
面瘫的治疗方法不断发展。了解面神经解剖结构以及评估面神经损伤程度的不同方法对于成功治疗至关重要。当面神经横断时，直接吻合可获得最佳效果，其次是神经移植。在运动终板仍完好但一期修复或移植不可行的情况下，应采用神经移位术。当出现完全性肌肉萎缩时，可选择局部肌肉转移或游离皮瓣重建。当无法进行动态重建时，静态手术也有一定益处。肉毒毒素注射和生物反馈等辅助工具可能会有所帮助。有几种新的治疗方式即将出现，它们有可能改变当前的治疗方案。
