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兔面神经-颈袢与面神经-舌下神经之间的吻合：用于周围性面瘫的实用技术说明

Anastomosis between the facial nerve - ansa cervicalis and the facial nerve - hypoglossal nerve in rabbits: technical note for a practical use in peripheral facial palsy.

作者信息

Balaci Georgeta Magdalena, Major Zoltan Zsigmond, Radu Oana Maria, Sălăgean Raul, Florian Ioan Ṣtefan

机构信息

Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

Department of Neurosurgery, Emergency County Hospital, Cluj-Napoca, Romania.

出版信息

Med Pharm Rep. 2023 Oct;96(4):400-405. doi: 10.15386/mpr-2665. Epub 2023 Oct 26.

DOI:10.15386/mpr-2665
PMID:37970194
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10642742/
Abstract

BACKGROUND AND AIMS

To emphasize the importance of laboratory dissections in perfecting surgical techniques. In this paper, we describe the technical details on rabbit dissection for practical applications.

METHODS

Four New Zealand rabbits were distributed into two groups and underwent anastomosis between the Facial Nerve and Ansa Cervicalis (group 1) and between the Facial Nerve and Hypoglossal Nerve (group 2). They were clinically and neurophysiologically evaluated after ten weeks. Electroneurography with skin electrodes were used to identify the motor activity of the involved muscles and nerves. Facial and ipsilateral tongue reinnervation was analyzed 40 weeks after anastomosis. Evoked electromyographic muscle tension was used to evaluate facial and tongue reinnervation.

RESULTS

Facial and ipsilateral tongue reinnervation was analyzed 40 weeks after anastomosis. Recorded evoked potentials showed improvement in facial reinnervation in all four rabbits. Rabbits undergoing FN-HN anastomosis still showed ipsilateral lingual paresis, based on EMG tests. The survival rate was 100%.

CONCLUSIONS

The laboratory dissection plays a crucial role in training surgical specialists to achieve favorable patient outcomes. Both types of anastomosis can be used to achieve facial reinnervation; however, it is imperative to prevent ipsilateral lingual paralysis that may arise from using the hypoglossal nerve.

摘要

背景与目的

强调实验室解剖在完善手术技术方面的重要性。在本文中，我们描述了用于实际应用的兔解剖技术细节。

方法

将4只新西兰兔分为两组，分别进行面神经与颈袢（第1组）以及面神经与舌下神经（第2组）的吻合术。10周后对它们进行临床和神经生理学评估。使用皮肤电极进行神经电图检查以识别相关肌肉和神经的运动活性。吻合术后40周分析面部和同侧舌的再支配情况。使用诱发肌电图肌肉张力来评估面部和舌的再支配情况。

结果

吻合术后40周分析面部和同侧舌的再支配情况。记录的诱发电位显示所有4只兔的面部再支配均有改善。基于肌电图测试，接受面神经 - 舌下神经吻合术的兔仍表现出同侧舌瘫。存活率为100%。

结论

实验室解剖在培训外科专家以实现良好的患者预后方面起着关键作用。两种吻合方式均可用于实现面部再支配；然而，必须防止使用舌下神经可能引起的同侧舌麻痹。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f425/10642742/0279f5b4a1b1/cm-96-400f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f425/10642742/18f276df5d67/cm-96-400f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f425/10642742/0279f5b4a1b1/cm-96-400f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f425/10642742/18f276df5d67/cm-96-400f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f425/10642742/0279f5b4a1b1/cm-96-400f2.jpg

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Strategies to Improve Cross-Face Nerve Grafting in Facial Paralysis.改善面瘫患者面-神经移植术的策略。
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Masseter-to-Facial Cranial Nerve Anastomosis: A Report of 30 Cases.咬肌至面神经颅外吻合术：30例报告
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Using the Post-Descendens Hypoglossal Nerve in Hypoglossal-Facial Anastomosis: An Anatomic and Histologic Feasibility Study.在舌下-面神经吻合术中使用舌下神经降支：一项解剖学和组织学可行性研究。
Oper Neurosurg. 2020 Sep 15;19(4):436-443. doi: 10.1093/ons/opz408.
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Reconstruction of complex defects of the extracranial facial nerve: technique of "the trifurcation approach".颅外面神经复杂缺损的重建：“三叉分支入路”技术
Eur Arch Otorhinolaryngol. 2019 Jun;276(6):1793-1798. doi: 10.1007/s00405-019-05418-4. Epub 2019 Apr 4.
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