Pellat J L, Bonnefille E, Zanaret M, Cannoni M
Service de Chirurgie Plastique et Reconstructrice, Hôpital de la Timone, Marseille, France.
Ann Chir Plast Esthet. 1997 Feb;42(1):37-43.
The authors report their experience of 60 cases of hypoglosso-facial anastomosis. The results of this retrospective series were analysed by the same examiner according to the House and Brackmann classification. The surgical technique is rapidly described, with emphasis on the important points. The results are analysed as a function of the interval between the anastomosis and facial paralysis: better and more rapid results are obtained when surgery is performed early (80% of grade 3 with immediate surgery versus 50% in very late surgery after more than 4 years). However, grade 3 or 4 can be obtained in every case, even in the case of very late surgery. Other favourable prognostic factors were revealed by this study: specialized rehabilitation and especially the patient's psychological must be integrated in this nerve transfer. In view of these good results and the limited adverse effects (atrophy of the hemi-tongue, eye-mouth synkinesias), hypoglosso-facial anastomosis must be part of the therapeutic strategy of total, permanent facial paralysis.
作者报告了他们60例舌下-面神经吻合术的经验。由同一位检查者根据豪斯和布拉克曼分类法对这个回顾性系列病例的结果进行分析。快速描述了手术技术，并强调了要点。根据吻合术与面瘫之间的间隔时间对结果进行分析：早期手术能获得更好、更快的效果（即刻手术80%达到3级，而4年多后极晚期手术仅为50%）。然而，即使是极晚期手术，每个病例都能达到3级或4级。这项研究还揭示了其他有利的预后因素：专业康复治疗，尤其是患者的心理因素必须纳入这种神经移植治疗中。鉴于这些良好的结果以及有限的不良反应（半侧舌萎缩、眼口联动），舌下-面神经吻合术必须成为完全性、永久性面瘫治疗策略的一部分。
