Oldfors A, Mair W G, Fogdestam I
Department of Pathology, Sahlgrenska Hospital, Göteborg, Sweden.
Scand J Plast Reconstr Surg Hand Surg. 1989;23(1):35-42. doi: 10.3109/02844318909067506.
Muscle biopsies from two patients treated by free gracilis muscle transfer and micro-neurovascular anastomoses for long standing facial palsy due to previous damage to the facial nerve during removal of tumours were examined by histochemistry and electron microscopy. Sequential muscle biopsies of one case taken at various intervals after transferring the muscle permitted the study of events of de- and reinnervation of human skeletal muscle. The changes in the early stages of denervation included atrophy of type 2B fibres. This was followed by progressive atrophy of all fibre types, distortion of the internal structure of the muscle fibres with the incidence of various cytoplasmic inclusions. Massive necrosis of the muscle did not occur. A prominent increase in satellite cells and their maturation to myotubes and new muscle fibres were evident. Reinnervation occurred with the formation of neuromuscular junctions some of them being at preformed sole plates. Fibre type grouping was apparent in addition to other changes such as the occurrence of targetoid hypertrophied muscle fibres. These changes are similar to those described previously during de- and reinnervation studies in experimental animals.
对两名因先前在肿瘤切除过程中面神经受损而导致长期面瘫，接受游离股薄肌转移和显微神经血管吻合术治疗的患者的肌肉活检组织进行了组织化学和电子显微镜检查。对其中一例患者在转移肌肉后的不同时间间隔进行的连续肌肉活检，使得对人类骨骼肌去神经和再神经支配过程的研究成为可能。去神经早期的变化包括2B型纤维萎缩。随后所有纤维类型逐渐萎缩，肌纤维内部结构扭曲，出现各种细胞质内含物。未发生肌肉大规模坏死。卫星细胞显著增加，并成熟为肌管和新的肌纤维。再神经支配伴随着神经肌肉接头的形成，其中一些位于预先形成的终板处。除了其他变化，如靶样肥大肌纤维的出现外，纤维类型分组也很明显。这些变化与先前在实验动物的去神经和再神经支配研究中所描述的变化相似。
