带神经血管股薄肌游离肌瓣应用于晚期面瘫修复  

Application of Free Flap of Neurovascular Gracilis Muscle in Repair of Late Facial Paralysis

作　　者：梁虹宇 李养群 LIANG Hongyu;LI Yangqun(Department Two of Plastic Surgery,Plastic Surgery Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100144,China)

机构地区：[1]中国医学科学院北京协和医学院整形外科医院整形二科

出　　处：《医学综述》2019年第19期3875-3879,共5页Medical Recapitulate

摘　　要：采用带神经血管肌瓣移植治疗晚期面瘫术后可出现较为自主、对称和自然的表情运动,其被多数学者认为是迄今为止重建面神经瘫痪患者面部动力最为有效的一种方法。股薄肌作为重建显微外科手术中最有价值的供体肌肉,在重建面神经瘫痪患者的面部动力上已经取得了相当大的成功。在无面动脉或颞浅血管的情况下,移植肌血管可与颏下血管吻合;闭孔神经不仅可以与跨面神经或咬肌神经吻合,还可与双运动神经吻合,术后有效改善患侧面部动力;另外,移植股薄肌游离肌瓣重量的精确程度也是影响手术疗效的重要因素;近年来国内外学者通过提高传统术式,在很大程度上改进了股薄肌游离肌瓣治疗晚期面瘫的手术效果。The transplantation of neurovascular muscle flap for the treatment of late facial paralysis can present more autonomous,symmetrical and natural facial movement after operation,which is considered by most scholars to be the most effective treatment method so far.Gracilis muscle,as a valuable donor muscle in reconstructing microsurgery,has achieved considerable success in the reconstruction of facial motor in patients with facial nerve paralysis.In the absence of facial artery or superficial temporal artery,vessel of transplanted muscle can be anastomosed with the submental vessels.The obturator nerve can not only be anastomosed with cross-facial nerve or masseter nerve,but also both of them,which can effectively improve the dynamic force of the affected side.Besides,the precision of the weight of the transplanted free gracilis muscle flap is also an important factor to the success of the operation.In recent years,through the improvement of the traditional sugery,domestic and foreign experts have greatly improved the surgical effect of gracilis muscle free flap in the treatment of late facial paralysis.

关 键 词：股薄肌 晚期面瘫 神经血管肌肉移植 游离肌瓣 显微外科 

分 类 号：R622.2[医药卫生—整形外科]