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小脑桥脑角肿瘤切除术后面神经麻痹导致的面部恢复

Reanimation of the face after facial nerve palsy resulting from resection of a cerebellopontine angle tumour.

作者信息

Kukwa A, Marchel A, Pietniczka M, Rakowicz M, Krajewski R

机构信息

Department of Otolaryngology, Warsaw Medical School, Poland.

出版信息

Br J Neurosurg. 1994;8(3):327-32. doi: 10.3109/02688699409029621.

Abstract

Twenty-three patients with facial nerve paralysis following surgery for a cerebellopontine angle tumour had a facial-hypoglossal anastomosis and simultaneous anastomosis of the cervical ansa with the distal stump of the hypoglossal nerve. In 18 patients, simultaneously with the neural anastomoses, additional transpositions of the temporalis and masseter muscles were performed. At follow-up examination 3-87 months after reconstructive surgery, eight patients had House grade II, ten grade III and five grade IV outcome. The EMG evidence of reinnervation was observed 5-11 months after anastomosis. Combination of the facial-hypoglossal anastomosis with simultaneous myoplasty and with anastomosis of the distal hypoglossal nerve stump to the ansa cervicalis provides the advantage of immediate protection against ophthalmic complications, prevents hemiatrophy of the tongue and gives good functional results when reinnervation of the facial muscles takes place.

摘要

23例因桥小脑角肿瘤手术导致面神经麻痹的患者接受了面-舌下神经吻合术,并同时将颈袢与舌下神经远心端残端进行吻合。18例患者在进行神经吻合的同时,还额外进行了颞肌和咬肌转位术。在重建手术后3 - 87个月的随访检查中,8例患者的House分级为Ⅱ级,10例为Ⅲ级,5例为Ⅳ级。吻合术后5 - 11个月观察到神经再支配的肌电图证据。面-舌下神经吻合术联合同期肌成形术以及舌下神经远心端残端与颈袢吻合术,具有即时预防眼部并发症的优势,可防止舌半侧萎缩,并且在面部肌肉发生神经再支配时能取得良好的功能效果。

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