Darrouzet V, Dutkiewicz J, Chambrin A, Stoll D, Bébéar J P
CHU Pellegrin, Clinique Universitaire O.R.L., Bordeaux, France.
Rev Laryngol Otol Rhinol (Bord). 1997;118(3):203-10.
The authors report their experience with 31 hypoglosso-facial anastomoses mainly carried out after removal of tumours of the cerebello-pontine angle, 26 were available for evaluation: at 18 months there were 5 of grade II, 19 of grade IV and 2 of grade V. Only one patient was dissatisfied with the result. 24 of the patients had received their hypoglosso-facial anastomosis using the clinical technique of Korte. In 3 cases the operation was by the technique of May. The authors suggest a variation of May's technique: it was carried out on the last 4 patients. It consists of a hemi-hypoglosso-facial anastomosis with rerouting of the mastoid portion of the facial nerve, without using a nerve graft. The aim of this technique is to reduce the sequelae of hemi-lingual atrophy and paralysis (which gives trouble with articulation, mastication and deglutition). The authors' experience confirms that these sequelae are greatly reduced, if not abolished. The functional results in terms of facial movements were satisfactory and consistant: 43.7% were quantified--with 3 of grade II and one of grade IV on the House Brackmann scale.
作者报告了他们主要在切除桥小脑角肿瘤后进行31次舌下-面神经吻合术的经验,其中26例可供评估:18个月时,II级有5例,IV级有19例,V级有2例。只有1例患者对结果不满意。24例患者采用Korte临床技术进行舌下-面神经吻合术。3例手术采用May技术。作者提出了May技术的一种变体:在最后4例患者身上实施。它包括半舌下-面神经吻合术,同时对面神经的乳突部分进行改道,不使用神经移植。该技术的目的是减少半舌萎缩和麻痹的后遗症(这会给发音、咀嚼和吞咽带来麻烦)。作者的经验证实,这些后遗症即使没有消除,也会大大减少。面部运动方面的功能结果令人满意且一致:43.7%进行了量化——根据House Brackmann量表,II级有3例,IV级有1例。