Department of Otolaryngology-Head and Neck Surgery, LSU Health Sciences Center New Orleans, Baton Rouge, Louisiana.
College of Medicine, LSU Health Sciences Center New Orleans, Baton Rouge, Louisiana.
Facial Plast Surg. 2021 Aug;37(4):490-499. doi: 10.1055/s-0041-1725129. Epub 2021 Mar 1.
Acute soft tissue trauma to the head and neck is a common reason for emergency department presentation and should be appropriately evaluated by a facial plastic surgeon. The evaluation of a patient who has suffered facial trauma should always include a comprehensive facial nerve exam and carry a low threshold of suspicion for parotid duct injury when involving the cheek. Injuries to the facial nerve and parotid duct can result in significant long-term functional, cosmetic, and emotional morbidity, particularly when diagnosis is delayed. In the repair of facial nerve transection, neurorrhaphy technique is primarily based on the ability to obtain tension-free anastomosis and outcomes are in large part related to timing of repair. Parotid duct injuries are generally repaired based on the site of ductal injury. In this article, we present a guide to the relevant anatomy of the facial nerve branches and the parotid duct, the important factors guiding treatment decisions alongside their related risks and benefits, as well as the management of complications of facial nerve neurorrhaphy and parotid duct injuries and repair.
头颈部急性软组织创伤是急诊科就诊的常见原因，应由面部整形外科医生进行适当评估。对于面部创伤患者的评估，始终应包括全面的面神经检查，并在涉及脸颊时对腮腺管损伤保持低怀疑阈值。面神经和腮腺管损伤可导致严重的长期功能、美容和情感发病率，尤其是当诊断延迟时。在面神经横断伤修复中，神经吻合技术主要基于获得无张力吻合的能力，其结果在很大程度上与修复时机有关。腮腺管损伤通常根据管损伤的部位进行修复。在本文中，我们介绍了面神经分支和腮腺管的相关解剖结构指南、指导治疗决策的重要因素及其相关风险和益处，以及面神经神经吻合和腮腺管损伤修复并发症的处理。
