Aszmann O C, Muse V, Dellon A L
Division of Plastic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Ann Plast Surg. 1996 Nov;37(5):520-5. doi: 10.1097/00000637-199611000-00011.
The extent and time course of sensory recovery has been investigated in 13 patients who had resection of a cutaneous nerve. Seven patients were studied within 8 weeks of denervation; 6 others were studied more than 6 months after denervation. Touch sensation was evaluated using a computer-assisted measuring device that recorded the pressure thresholds for static and moving touch, and static and moving two-point discrimination within a continual range from 0.1 to 100 gm per square millimeter. Recovery of sensation within the autonomous zone of the resected nerve could be documented as early as 3 weeks after denervation. After 6 months, two-point discrimination had recovered in the previously denervated areas. Thresholds for all test modalities were found to be elevated within the sensory distribution of adjacent nerves, which suggests that these areas have been the donor source for reinnervation of the chronically denervated territory. Anesthetic block of these adjacent donor nerves resulted in loss of the recovered sensation.
对13例接受皮神经切除术的患者的感觉恢复程度及时间进程进行了研究。7例患者在去神经支配后8周内接受研究;另外6例患者在去神经支配6个月后接受研究。使用计算机辅助测量设备评估触觉,该设备记录了每平方毫米0.1至100克连续范围内静态和动态触觉的压力阈值以及静态和动态两点辨别力。在去神经支配后3周即可记录到切除神经自主区内的感觉恢复。6个月后,先前去神经支配区域的两点辨别力已恢复。发现在相邻神经的感觉分布区内,所有测试模式的阈值均升高,这表明这些区域是慢性去神经支配区域重新神经支配的供体来源。对这些相邻的供体神经进行麻醉阻滞会导致恢复的感觉丧失。