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颞肌延长肌成形术与面神经麻痹患者吞咽口腔期功能障碍的改善

Lengthening temporalis myoplasty and reduction of the swallowing oral phase dysfunction in facial palsy patients.

作者信息

Croisé Benjamin, Paré Arnaud, Marmouset Franck, Bregeaut Paul, Joly Aline, Laure Boris

机构信息

Department of Maxillofacial and Plastic Facial Surgery, Trousseau Hospital, Tours 37000, France; University of François Rabelais, school of medicine, Tours 37000, France.

Department of Maxillofacial and Plastic Facial Surgery, Trousseau Hospital, Tours 37000, France; University of François Rabelais, school of medicine, Tours 37000, France.

出版信息

J Plast Reconstr Aesthet Surg. 2019 Jul;72(7):1157-1163. doi: 10.1016/j.bjps.2019.02.027. Epub 2019 Mar 1.

Abstract

INTRODUCTION

Facial palsy can cause dysfunction in the oral phase of swallowing. Lengthening temporalis myoplasty is a widely used technique for correction of facial asymmetry in facial palsy. The aim of this study was to determine whether lengthening temporalis myoplasty could reduce the dysfunction in the oral phase of swallowing in patients with facial palsy.

MATERIALS AND METHODS

This prospective study enrolled 13 patients undergoing lengthening temporalis myoplasty. Lip continence, bolus residue, and perceived disability before surgery and at 3 months and 6 months after surgery were compared. Lip force was evaluated with a manometric test and drooling with a self-administered questionnaire. Bolus residue was assessed visually. Perceived disability was evaluated using a self-administered questionnaire.

RESULTS

Lip force improved significantly (from 58.23 ± 23.35 mmHg to 91.15 ± 18.36 mmHg; p = 0.001). Drooling showed a corresponding reduction, with the score decreasing from 4.31 ± 1.8 to 3 ± 1.41; p = 0.025. A decrease in bolus residue was also noted; the score decreased from 1.39 ± 0.77 to 0.46 ± 0.66; p < 0.001. These changes contributed to a significant reduction in perceived physical disability; the score decreased from 6.15 ± 3.74 to 3.46 ± 5.70; p = 0.004).

CONCLUSION

Lengthening temporalis myoplasty, in addition to providing smile reanimation, may also reduce the dysfunction of the oral phase of swallowing in patients with facial palsy.

摘要

引言

面神经麻痹可导致吞咽口腔期功能障碍。颞肌延长肌成形术是一种广泛应用于矫正面神经麻痹面部不对称的技术。本研究的目的是确定颞肌延长肌成形术是否能减少面神经麻痹患者吞咽口腔期的功能障碍。

材料与方法

本前瞻性研究纳入了13例行颞肌延长肌成形术的患者。比较术前、术后3个月和6个月时的唇部节制能力、食团残留情况和感知到的残疾程度。通过压力测试评估唇部力量,通过自我填写问卷评估流口水情况。通过视觉评估食团残留情况。使用自我填写问卷评估感知到的残疾程度。

结果

唇部力量显著改善(从58.23±23.35mmHg提高到91.15±18.36mmHg;p=0.001)。流口水情况相应减少,评分从4.31±1.8降至3±1.41;p=0.025。食团残留也有所减少;评分从1.39±0.77降至0.46±0.66;p<0.001。这些变化导致感知到的身体残疾显著降低;评分从6.15±3.74降至3.46±5.70;p=0.004)。

结论

颞肌延长肌成形术除了能恢复笑容外,还可能减少面神经麻痹患者吞咽口腔期的功能障碍。

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