Okochi Masayuki, Ueda Kazuki, Okochi Hiromi, Asai Emiko, Sakaba Takao, Kajikawa Akiyoshi
Department of Plastic and Reconstructive Surgery, Fukushima Medical University, Fukushima City, Fukushima, 960-1295, Japan.
Microsurgery. 2016 Sep;36(6):460-6. doi: 10.1002/micr.22393. Epub 2015 Aug 28.
In this report, we described the use of hypoglossal-facial neurorrhaphy with end-to-side coaptation between the jump interpositional nerve graft and the hypoglossal nerve for facial reanimation and analyzed the relationship between the outcome of surgery and duration of preoperative paralysis.
We performed hypoglossal-facial neurorrhaphy with the jump interpositional nerve graft on nine men and 10 women with unilateral complete facial paralysis. The patients, with a mean age of 39.7 ± 18.1 years (range, 8-65 years) at the time of surgery, experienced preoperative paralysis ranging from 1 to 150 months (mean, 16.9 ± 34.9 months). The movement of the corners of the mouth was evaluated 12 months after surgery using a unique method based on the House-Brackmann grading scale.
The mean follow-up was 5.6 ± 1.6 years (range, 3-9 years). The movement of the corners of mouth was classified as excellent in two cases, good in seven cases, fair in two cases, and poor in eight cases. Nine of the 11 cases with preoperative paralysis of 6 months or less had excellent or good results, whereas none of the eight cases with preoperative paralysis of 7 months or longer yielded excellent or good results, showing a significant difference (P = 0.01).
To achieve successful reanimation of the corners of the mouth, hypoglossal-facial neurorrhaphy with end-to-side coaptation between the jump interpositional nerve graft and the hypoglossal nerve should be performed within 6 months after the onset of facial nerve paralysis. © 2015 Wiley Periodicals, Inc. Microsurgery 36:460-466, 2016.
在本报告中，我们描述了采用舌下-面神经吻合术，在跳跃式移植神经与舌下神经之间进行端-侧吻合以恢复面部功能，并分析了手术效果与术前面瘫持续时间之间的关系。
我们对9名男性和10名女性单侧完全性面瘫患者实施了带跳跃式移植神经的舌下-面神经吻合术。手术时患者的平均年龄为39.7±18.1岁（范围为8 - 65岁），术前面瘫持续时间为1至150个月（平均为16.9±34.9个月）。术后12个月，采用基于House-Brackmann分级量表的独特方法对面口角运动进行评估。
平均随访时间为5.6±1.6年（范围为3 - 9年）。口角运动评为优的有2例，良的有7例，可的有2例，差的有8例。术前面瘫6个月或更短时间的11例患者中有9例结果为优或良，而术前面瘫7个月或更长时间的8例患者中无一例结果为优或良，差异有统计学意义（P = 0.01）。
为成功实现口角的功能恢复，应在面神经麻痹发病后6个月内进行带跳跃式移植神经与舌下神经端-侧吻合的舌下-面神经吻合术。©2015威利期刊公司。显微外科学36:460 - 466，2016年。
