咬肌神经-面神经吻合治疗面瘫的临床疗效观察  

Clinical observation of masseter-to-facial nerve anastomosis for treatment of facial paralysis

作　　者：马赛[2] 单小峰[1] 李仕骏 李梓萌 蔡志刚[1] 

机构地区：[1]北京大学口腔医学院,口腔医院口腔颌面外科,北京100081 [2]河北北方学院附属第一医院口腔科

出　　处：《中华显微外科杂志》2017年第5期441-444,共4页Chinese Journal of Microsurgery

基　　金：北京大学口腔医院新技术新疗法项目（16A10）

摘　　要：目的通过对咬肌神经-面神经吻合治疗面瘫的临床疗效分析，初步探讨影响手术预后的相关因素。方法回顾性分析2015年1月至2016年5月收治的6例行面神经修复患者的临床资料，患者均采用咬肌神经-面神经吻合的手术方法。术后每3个月复查，观察面神经功能恢复情况。应用House-Brackmann（HB）评分方法对患者术前、术后面神经功能进行评估。结果6例均随访，随访时间6~23个月，平均16个月。有效5例，无效1例，其中面神经干功能恢复至H-B II级3例，H-B III级2例。口轮匝肌的功能改善最为显著，其次是眼轮匝肌，而额肌改善最差。结论咬肌神经-面神经吻合是治疗面瘫的一种有效方法，能够改善多数患者的面神经功能。ObjectiveTo evaluate the efficiency and functional improvement of masseter-to-facial nerve transfer for patients who acquired a proximal iniury to the facial nerve and preliminary determine the influence factors for recovery.MethodsFrom January, 2015 to May, 2016, the clinical data of 6 patients with facial paralysis underwent nerve anastomosis were analyzed retrospectively. These patients were required to come back to the hospital for a check every 3 months, in order to evaluate their facial nerve function. House-Brackmann （H-B） grading was used to evaluate the pre-oerative, post-operative and follow-up status. The masseter-to-facial nerve anastomosis was performed in all the 6 patients.ResultsAll patients were followed-up. The mean time of follow-up was 16 months （ranged from 6 to 23 months） . Among 6 cases, the facial nerve function was improved in 5 cases, unchanged in 1 case. The postoperative H-B grades were II in 3 cases, III in 2 cases. The improvement of facial paralysis was most significant for orbicularis muscles, followed by the orbicularis oculi muscles, and the worst was the improvement of frontal muscles.ConclusionMasseter-to-facial nerve transfer anatomosis is a useful treatment for facial paralysis and can improve the facial function.

关 键 词：面瘫 咬肌神经 神经端端吻合 神经端侧吻合 

分 类 号：R651.3[医药卫生—外科学]