Sommerauer Laura, Engelmann Simon, Ruewe Marc, Anker Alexandra, Prantl Lukas, Kehrer Andreas
Department of Plastic, Hand and Reconstructive Surgery, University Medical Centre Regensburg, Regensburg, Germany.
Arch Plast Surg. 2021 May;48(3):278-281. doi: 10.5999/aps.2020.01025. Epub 2020 Sep 25.
Facial palsy (FP) is a functional disorder of the facial nerve involving paralysis of the mimic muscles. According to the principle "time is muscle," early surgical treatment is tremendously important for preserving the mimic musculature if there are no signs of nerve function recovery. In a 49-year-old female patient, even 19 months after onset of FP, successful neurotization was still possible by a V-to-VII nerve transfer and cross-face nerve grafting. Our patient suffered from complete FP after vestibular schwannoma surgery. With continuous application of electrostimulation (ES) therapy, the patient was able to bridge the period between the first onset of FP and neurotization surgery. The significance of ES for mimic musculature preservation in FP patients has not yet been fully clarified. More attention should be paid to this form of therapy in order to preserve the facial musculature, and its benefits should be evaluated in further prospective clinical studies.
面瘫(FP)是一种涉及表情肌麻痹的面神经功能障碍。根据“时间就是肌肉”的原则,如果没有神经功能恢复的迹象,早期手术治疗对于保留表情肌组织极为重要。在一名49岁女性患者中,即使在面瘫发病19个月后,通过V至VII神经转移和跨面神经移植仍有可能成功实现神经化。我们的患者在前庭神经鞘瘤手术后患上了完全性面瘫。通过持续应用电刺激(ES)疗法,患者得以度过面瘫首次发作至神经化手术之间的时期。ES对面瘫患者表情肌组织保留的意义尚未完全阐明。为了保留面部肌肉组织,应更加关注这种治疗形式,其益处应在进一步的前瞻性临床研究中进行评估。