改良舌下神经-面神经吻合术治疗脑桥梗死所致周围性面瘫：1例报告及文献复习
Modified hypoglossal-facial nerve anastomosis for peripheral-type facial palsy caused by pontine infarction: A case report and literature review.
作者信息
Cai Xiaomin, Wang Baimiao, Ying Tingting, Qian Mengshu, Li Shiting
机构信息
Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, The Cranial Nerve Disease Center of Shanghai Jiaotong University, Shanghai, 200092, China.
Department of Emergency and Critical Care Medicine, Kong Jiang Hospital of Yangpu District, Shanghai, 200082, China.
出版信息
Heliyon. 2023 Jun 1;9(6):e16909. doi: 10.1016/j.heliyon.2023.e16909. eCollection 2023 Jun.
BACKGROUND
Peripheral-type facial palsy could be caused by a lesion in the tegmentum of the pons, such as infarction, with a rare occurrence. We herein described a case of unilateral peripheral-type facial palsy induced by dorsolateral pontine infarction and treated this patient using modified hypoglossal-facial nerve anastomosis.
CASE PRESENTATION
A 60-year-old female presented with dizziness, hearing drop, diplopia, and peripheral-type facial palsy. Brain Magnetic Resonance Imaging showed a dorsolateral pontine infarction on the right side which exactly refers to the location of the ipsilateral facial nucleus or facial nerve fascicles at the pons. Subsequent electrophysiological examinations confirmed poor facial nerve function of this patient and modified hypoglossal-facial nerve anastomosis was then performed.
CONCLUSIONS
This case reminded medical practitioners not to ignore the possibility of involvement of a central cause in peripheral-type facial palsy patients. In addition, modified hypoglossal-facial nerve anastomosis served as a useful skill improvement that may help reduce hemiglossal dysfunction while restoring facial muscle function.
背景
周围性面瘫可能由脑桥被盖部病变引起，如梗死，其发生率较低。我们在此描述了1例由脑桥背外侧梗死引起的单侧周围性面瘫病例，并采用改良舌下-面神经吻合术对该患者进行治疗。
病例介绍
一名60岁女性出现头晕、听力下降、复视和周围性面瘫。脑部磁共振成像显示右侧脑桥背外侧梗死，该部位恰好对应脑桥同侧面神经核或面神经束的位置。随后的电生理检查证实该患者面神经功能较差，遂进行改良舌下-面神经吻合术。
结论
该病例提醒医生不要忽视周围性面瘫患者存在中枢性病因的可能性。此外，改良舌下-面神经吻合术是一项有用的技术改进，可能有助于在恢复面部肌肉功能的同时减少半侧舌功能障碍。
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