Matsunaga T, Kanzaki J, O-Uchi T, Kunihiro T, Ogata A, Inoue Y, Sato Y, Yoshiwara S
Department of Otolaryngology, School of Medicine, Keio University, Tokyo, Japan.
ORL J Otorhinolaryngol Relat Spec. 1995 May-Jun;57(3):153-60. doi: 10.1159/000276729.
Facial nerve specimens removed from ten patients who underwent hypoglossal-facial nerve anastomosis for facial palsy following removal of cerebellopontine angle tumors were studied histologically. Facial nerve function prior to the anastomosis surgery and the degree of postoperative functional recovery were compared with the histological results. The recovery of facial palsy after the anastomosis surgery was excellent or satisfactory in nine patients and the endoneurium within the nerve fascicles was well-preserved. The recovery of facial palsy was poor in one patient who had severe fibrosis of the endoneurium. The histological and ultrastructural features of the facial nerve were closely related to the occurrence of facial palsy prior to tumor removal, the status of the nerve after tumor removal, and the interval between tumor removal and anastomosis surgery. Based on these histological and functional relationships, the timing and indications for anastomosis surgery are discussed.
对10例因切除桥小脑角肿瘤后发生面瘫而行舌下神经-面神经吻合术的患者所切除的面神经标本进行了组织学研究。将吻合手术前的面神经功能及术后功能恢复程度与组织学结果进行了比较。9例患者吻合手术后面瘫恢复良好或满意，神经束内的神经内膜保存完好。1例患者神经内膜严重纤维化，面瘫恢复较差。面神经的组织学和超微结构特征与肿瘤切除前面瘫的发生、肿瘤切除后神经的状态以及肿瘤切除与吻合手术之间的间隔密切相关。基于这些组织学和功能关系，对吻合手术的时机和指征进行了讨论。
