Nakao Ko, Fujii Takako, Sakuma Hisashi
Department of Plastic and Reconstructive Surgery, Ichikawa General Hospital, Tokyo Dental College, Ichikawa, Japan.
Arch Plast Surg. 2025 May 15;52(3):125-131. doi: 10.1055/a-2531-3083. eCollection 2025 May.
Although postparalytic facial nerve syndrome (PFS) is a frequent sequela of partial facial palsy, no effective treatment is currently available. Herein, we report a case of a cross-face nerve graft (CFNG) technique with selective neurectomy of the facial nerve in a 52-year-old female with moderate PFS (especially oral-ocular synkinesis and facial contracture) and a House-Brackmann score grade III. Selective neurectomy resulted in the release of the synkinesis and contractures. Furthermore, we reinnervated the levator muscles of the upper lip and oral commissure by connecting the contralateral facial nerve to the thick zygomatic branch of the facial nerve via a CFNG, which allowed neural signal augmentation of the levator muscles. No obvious PFS recurrence was observed 1 year postoperatively. This procedure is expected to provide a new treatment option for improving PFS because it is effective and less invasive.
尽管麻痹后面神经综合征（PFS）是部分面神经麻痹常见的后遗症，但目前尚无有效的治疗方法。在此，我们报告一例52岁中度PFS（尤其是口眼联动和面部挛缩）且House-Brackmann分级为III级的女性患者，采用跨面神经移植（CFNG）技术并选择性切除面神经的病例。选择性神经切除术使联动和挛缩得到缓解。此外，我们通过CFNG将对侧面神经与面神经粗大的颧支相连，对上唇提肌和口角进行再支配，从而增强了提肌的神经信号。术后1年未观察到明显的PFS复发。该手术有望为改善PFS提供一种新的治疗选择，因为它有效且侵入性较小。
