Koshima I, Tsuda K, Hamanaka T, Moriguchi T
Department of Plastic and Reconstructive Surgery, Kawasaki Medical School, Okayama, Japan.
Plast Reconstr Surg. 1997 Jan;99(1):234-8. doi: 10.1097/00006534-199701000-00036.
A free vascularized rectus abdominis muscle graft with a long motor nerve was used for reconstruction of unilateral established facial paralysis in one stage. Regarding the procedure, the pedicle vessels were anastomosed to the recipient vessels in the ipsilateral face, and the motor nerve of the muscle was sutured to the contralateral facial nerve. The advantages of using the rectus abdominis muscle are as follows: (1) the muscle is very thin, not bulky, (2) the muscle can be split easily to reduce the volume, (3) the intercostal nerve is long enough (more than 20 cm) to reach the contralateral facial nerve for suturing, (4) the pedicle vessels are large and long, (5) it is possible to carry out simultaneous operations with two teams, and (6) the donor-site morbidity is minimal. The disadvantages of this method are that complicated surgical dissection is required to obtain a motor nerve and that a postoperative abdominal hernia may occur.
采用带长运动神经的游离血管化腹直肌肌瓣一期修复单侧陈旧性面瘫。手术时，将带蒂血管与同侧面部的受区血管吻合，肌瓣的运动神经与对侧面神经缝合。使用腹直肌的优点如下：（1）该肌非常薄，不臃肿；（2）可轻松劈开该肌以减小体积；（3）肋间神经足够长（超过20cm），可抵达对侧面神经进行缝合；（4）带蒂血管粗大且长；（5）可两个手术组同时进行手术；（6）供区并发症极少。该方法的缺点是获取运动神经需要复杂的手术解剖，且术后可能发生腹疝。
