Department of Plastic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
Department of Plastic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
J Plast Reconstr Aesthet Surg. 2018 May;71(5):750-757. doi: 10.1016/j.bjps.2018.01.008. Epub 2018 Jan 31.
Long-standing cases of facial paralysis are currently treated with free functional muscle transfer. Several nerves are mentioned in the literature to supply the free muscle transfer. The aim of this study is to compare the split hypoglossal nerve and the cross-face nerve graft to supply the free functional muscle transfer in facial reanimation. Of 94 patients with long-standing, unilateral facial palsy, 49 were treated using the latissimus dorsi muscle supplied by the split hypoglossal nerve, and 45 patients were treated using the latissmus dorsi muscle supplied by healthy contralateral buccal branch of the facial nerve. The excursion gained by the free muscle transfer supplied by the split hypoglossal nerve (mean 19.20 ± 6.321) was significantly higher (P value 0.001) than that obtained by the contralateral buccal branch of the facial nerve (mean 14.59 ± 6.245). The split hypoglossal nerve appears to be a good possible option to supply the free vascularised muscle transfer in facial reanimation. It yields a stronger excursion in less time than the contralateral cross-face nerve graft.
目前，对于长期面瘫的患者，采用游离功能性肌肉移植进行治疗。文献中提到了几种神经来为游离肌肉移植提供供应。本研究旨在比较舌下神经分束和跨面神经移植在面部再神经化中为游离功能性肌肉移植提供供应的效果。在 94 例长期单侧面瘫患者中，49 例采用舌下神经分束供应的背阔肌进行治疗，45 例采用健侧面神经颊支供应的背阔肌进行治疗。舌下神经分束供应的游离肌肉移植获得的活动度（平均 19.20 ± 6.321）明显高于健侧面神经颊支（平均 14.59 ± 6.245）（P 值 0.001）。舌下神经分束似乎是为面部再神经化提供游离血管化肌肉移植的一个很好的选择。它比健侧面神经交叉移植产生更强的活动度，所需时间更短。
