晚期面瘫畸形解剖亚单位分区手术效果评价  

Effectiveness of plastic procedures managed with anatomic sub-unit zone on advanced facial paralysis

作　　者：黄渭清[1] 曾昂[1] 张海林[1] 王智[1] 宋可新[1] 白明[1] 龙笑[1] 王晓军[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院整形外科,100730

出　　处：《中华医学美学美容杂志》2015年第3期129-132,共4页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：“十二五”国家科技支撑计划资助课题（2012BAI12B01）

摘　　要：目的 探讨晚期面瘫畸形解剖亚单位分区的手术效果.方法 对2003年3月至2013年12月533例面瘫患者进行整形外科手术治疗,根据面神经分支所支配的解剖区域,将治疗部位分为眉毛、上睑、下睑、上唇和颊部以及下唇等亚单位,分别进行眉畸形整形,上睑植入假体矫正外翻畸形,下睑外翻通过颞肌瓣转移修复,上唇和颊部通过小肌肉游离移植悬吊术矫正畸形,下唇红唇整形术等相应的术式治疗.采用Douglas Harrison方法评价面神经麻痹治疗效果和Stennert国际评分评价面神经麻痹程度.结果 533例患者中,Douglas Harrison标准评价效果满意475例,占89.1％;较好48例,占9.0％;不明显6例,占1.1％.按照Stennert评分标准,533例（100.0％）静态畸形分在1分以下（满分4）;475例（89.1％）动态畸形分在2分以下（满分6）,出现并发症6例（1.1％）.结论 根据面瘫患者的不同部位的畸形程度与亚单位解剖分区选择术式,不但可提高面瘫的治疗效果,而且可防止和减少手术并发症.Objective To investigate the surgical efficacy of the anatomic subunit zone and affiliated procedures on long-standing facial palsy.Methods A total of 533 long-standing facial palsy cases were treated from Mar.2003 to Dec.2013 according to the anatomic division into the subunit：eyebrow,upper eyelid and lower eyelid,upper lip and lower lip,and chin.The surgical procedures were done to prevent complications：skin resection for eyebrow plasty,heavy implant for upper eyelid plasty,temporal muscle transfer for lower eyelid plasty,and mini muscle transplantation for lip and chin.We evaluated the surgical effects by Douglas Harrison standard and the paralysis appearance by Stennert international score system.Results Of the above 533 cases evaluated by Douglas Harrison methods,475 （89％） were good,48 （9％） were satisfactory,and 6 （1％） were not obviously improved.The paralysis appearance evaluated by Stennert score system showed that 533 （100％） eases were less than 1 of static state score （full score was 4）,475 （89.1％） cases were less than 2 of dynamic state score （full score of 6）.Conclusions The proper procedures combined with the deformity location and symptoms with subunit anatomy in facial palsy cases seem to be safe and effective,which not only improve the successful rate of surgery,but also prevent the complications.

关 键 词：晚期面瘫 综合整形 并发症 预防 

分 类 号：R622[医药卫生—整形外科]