Stennert E
Arch Otorhinolaryngol. 1982;236(1):97-114. doi: 10.1007/BF00464062.
Contradictory clinical and electromyographical findings following operations on the facial nerve have given rise to an analysis of the functional anatomy of the mimic musculature. This has led to the isolation of two sphincter systems in one half of the face to which all muscles on that side belong and which are innervated independently. Because of post-operative fiber aberrations, the innervational autonomy of both systems is lost, thus leading to mass movements. Since each system contains a number of antagonists, a mutual blocking that is the result of the heteromorphous neurotization occurs, producing the symptoms of a residual paresis, although these "weak" muscles are well reinnervated. These anatomical-functional relationships also offer an explanation for the fact that a clinically visible functional rehabilitation of the frontalis muscle rarely occurs following a neuroplasty in the truncal region of the facial nerve. The term "autoparalytic syndrome" thus offers itself as a description of this pathomechanism.
面神经手术后出现的相互矛盾的临床和肌电图检查结果促使人们对面部表情肌的功能解剖学进行分析。这导致在半侧面部分离出两个括约肌系统,该侧所有肌肉均属于这两个系统,且它们由不同神经独立支配。由于术后纤维错乱,两个系统的神经支配自主性丧失,从而导致联动运动。由于每个系统都包含许多拮抗肌,因此会出现因异型神经支配而导致的相互阻断,尽管这些“无力”的肌肉已得到良好的再支配,但仍会产生残余麻痹的症状。这些解剖学与功能的关系也解释了为什么在面神经主干区域进行神经成形术后,临床上很少能看到额肌出现明显的功能恢复。因此,“自麻痹综合征”这一术语可用于描述这种病理机制。