胸锁乳突肌瓣转位修复晚期面瘫的疗效评价  

Evaluation on the effect of the pedicled sternocleidomastoid muscle flap for facial paralysis in the late stage

作　　者：王炜[1] 杨川[1] 

机构地区：[1]上海第二医科大学第九人民医院整复外科,上海200011

出　　处：《上海第二医科大学学报》2004年第8期612-614,共3页Acta Universitatis Medicinalis Secondae Shanghai

摘　　要：目的 评价胸锁乳突肌瓣转位术修复晚期面瘫的疗效。方法 对接受该术的21例晚期面瘫患者术后随访3～25月,测量患者手术前后标准正位照片,同时对口角形态、疤痕、面部皮肤松弛等情况加以分类、分析和比较。结果 手术前后,静态鼻翼对称情况无显著差异,而口角对称情况有显著差异(P<0.01);动态的鼻翼和口角对称情况,手术前后均有显著差异(P<0.01);患侧面宽,手术前后无显著变化。面颈部顺皮纹切口处疤痕不明显,而与皮纹成角切口处疤痕明显。术后患侧皮肤存在一定松弛,颈部凹陷所致心理压力不明显,未见副神经损伤情况。结论 胸锁乳突肌瓣转位术修复晚期面瘫疗效较好,患者面部对称情况明显改善,无显著的臃肿和颈部供区凹陷,仅在颈部耳垂下方疤痕略为明显。Objective To investigate and evaluate the effect of transposition of the pedicled sternocleidomastoid muscle flap (PSMF) for the dynamic reanimation of facial paralysis in the late stage. Methods Twenty-one cases were followed up for 3 to 25 months. The facial pictures in standard right position were measured by using software photoshop 6. 0 with the results statistically treated. In all cases the form of the corner of the mouth, the scar and the laxaion of the soft tissures on the affected side were evaluated separately. Results There was no significant diffe-rence in the static symmetry of the alae of nose, preoperatively and postoperatively. On the contrary, the dynamic symmetry of the alae of nose, the static and dynamic corner of mouth were both significantly different (P < 0. 01). The scar following the dermatoglyph was not pronounced, conversely being obvious. The soft tissues on the affected side were flaccid. The neck concave was unvisible. There was no injury to the accessory nerve. Conclusion The procedure produces good cosmetic effect. Improvement of facial symmetry is obvious postoperatively. There is no marked swelling of the soft tissues on the affected side and the neck concave. The scar under the ear-lobe is obvious.

关 键 词：胸锁乳突肌 肌瓣转位 面瘫 晚期 副神经损伤 

分 类 号：R651[医药卫生—外科学]