Conley J
Laryngoscope. 1986 Feb;96(2):140-5. doi: 10.1288/00005537-198602000-00003.
There have been dramatic improvements in the treatment of facial paralysis. These include the successful use of free autogenous nerve grafting, nerve crossover techniques, regional masticatory muscle transposition, and free muscle grafts. The techniques are applied to total, partial, and regional paresis. The bulk of information on rehabilitation of the face has come from clinical empiricism, but basic research in nerve and muscle physiology and attempts at multiple classifications regarding indications and criteria have added to the splendor of this drama. One facet that has not been emphasized is the use of cheiloplasty in long-standing facial paralysis. Long-standing facial paralysis has both a neural and muscular deficit that cannot be rectified by a single concept or operation. It is essential to regionalize the rehabilitation, implant a kinetic muscular potential, supply some static support and elevation, and address the nonfunctional muscles about the paralyzed lips. This latter concept includes lip shortening and lip-flap transposition. A coordinated combination of these techniques has the best opportunity of maximizing the improvement in long-standing facial paralysis associated with severe muscle atrophy.
面瘫的治疗已经取得了显著进展。这些进展包括成功应用自体游离神经移植、神经交叉技术、区域性咀嚼肌转位和游离肌肉移植。这些技术适用于完全性、部分性和区域性麻痹。关于面部康复的大部分信息来自临床经验，但神经和肌肉生理学的基础研究以及针对适应症和标准的多种分类尝试，为这一进展增添了光彩。一个未被强调的方面是在长期面瘫中使用唇成形术。长期面瘫既有神经缺陷也有肌肉缺陷，无法通过单一概念或手术来纠正。对面部康复进行区域化、植入动态肌肉潜能、提供一些静态支撑和提升，并处理瘫痪嘴唇周围的无功能肌肉至关重要。后一个概念包括唇部缩短和唇瓣转位。这些技术的协同组合最有可能最大限度地改善与严重肌肉萎缩相关的长期面瘫。
