外伤性面瘫的早期手术治疗  

Surgical treatment of early traumatic injuries to the facial nerve

作　　者：宋维铭[1] 孙广慈[1] 冯越蹇[1] 蒋海越[1] 马继光[1] 何祯平[1] 

机构地区：[1]中国医学科学院中国协和医科大学整形外科医院,北京100041

出　　处：《中华医学美学美容杂志》2001年第5期244-247,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的　探讨外伤性面瘫手术时机和手术方法的选择 ,强调神经外瘢痕松解切除和严格遵守显微外科无创原则 ,结合神经损伤的形态特点 ,针对性选择优选用吻合神经方法的重要性。方法　 1993年 12月～1997年 11月 ,收治外伤性面瘫病人 7例 ,于伤后 3～ 4个月采用显微外科技术进行面神经吻合及腓肠神经眼轮匝肌植入术进行修复。结果　术后随访 6个月～ 2年 ,均获得了比较满意的面肌功能恢复。结论　外伤性面瘫 ,争取早日手术是成功的关键。方法宜首选面神经吻合、神经移植肌肉内植入术 ,对整复某些外伤后面瘫有其临床应用价值和适应证。Objective To investigate the choices of the timing and methods of the surgical operation after traumatic injuries to the facial nerve, and to emphasize the importance of the excision of perineauial scar,technique of microsurgery with no injuries and the methods selected for nerve coaptation according to the morphologic feature of the injuried nerve.Methods From December 1993 to November 1997, by microsurgical technique, seven cases with traumatic injuries to the facial nerve were treated in two stages from three months to four months after the trauma. Different methods were used including facial nerve anastomosis and implantation of the sural nerve transplant into the muscle. Results All cases have been followed up for six months to two years. The results of functional rehabilitation were excellent. Conclusions Whenever possible, the authors emphasize that the early repair with microsurgical technique should be performed to all of facial nerve with injury. Facial nerve anastomosis is the best choice for repair of early facial nerve severance. Implantation of nerve transplant into muscle has a certain clinical value of and the indication for the treatment of nerve injury.

关 键 词：面瘫 神经吻合术 神经移植肌肉内植入术 

分 类 号：R651.3[医药卫生—外科学]