舌下神经-面神经侧端吻合术治疗小脑脑桥角肿瘤术后面瘫  

Side-to-end hypoglossal to facial nerve anastomosis for facial reanimation after cerebellopontine angle tumor resection

作　　者：陈哲 王智立 柴永川[1] 汪照炎[1] CHEN Zhe;WANG Zhi-li;CHAI Yong-chuan;WANG Zhao-yan(Department of Otolaryngology Head and Neck Surgery,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Ear Institute,Shanghai Jiao Tong University School of Medicine,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属第九人民医院耳鼻咽喉头颈外科上海交通大学医学院耳科学研究所上海市耳鼻疾病转化医学重点实验室

出　　处：《中国耳鼻咽喉颅底外科杂志》2020年第1期28-31,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：国家自然科学基金面上项目(81870713、81670919)

摘　　要：目的探讨舌下神经-面神经侧端吻合术治疗小脑脑桥角肿瘤术后面瘫的效果。方法6例小脑脑桥角肿瘤切除术后面瘫患者均行舌下神经-面神经侧端吻合术。所有患者术后每3个月随访1次,评估House-Brackmann(H-B)分级和舌下神经功能。结果术后1年H-B III级2例,H-BⅣ级3例,H-B V级1例。静态面部张力4例患者在吻合术后6个月改善明显,1例患者在吻合术后9个月改善,1例患者在吻合术后1年改善。所有患者均未出现术侧舌肌瘫痪萎缩,发音和吞咽功能均正常。结论舌下神经-面神经侧端吻合术可改善小脑脑桥角肿瘤切除术后面瘫患者的面部张力和面肌功能,借助神经监护可尽量减小对舌肌功能的影响。Objective To investigate surgical effect of side-to-end hypoglossal to facial nerve anastomosis after cerebellopontine angle tumor resection.Methods A total of 6 patients underwent tumor resection in cerebellopontine angle received side-to-end hypoglossal to facial nerve anastomosis. All patients were followed up every three months, and their grade of House-Brackmann(H-B) and tongue function were evaluated.Results One year after surgery, 2 patients achieved H-B grade III,3 grade IV, and one grade V. Four patients achieved good facial tone at 6 months after reconstructive surgery, and the rest achieved at 9 months and one year respectively. Significant tongue atrophy, impaired tongue mobility, speech or swallow dysfunction occurred in none.Conclusions Side-to-end hypoglossal to facial nerve anastomosis is an efficient way to reanimate facial paralysis after cerebellopontine angle tumor resection. Intraoperative nerve monitor may be beneficial to the protection of tongue function.

关 键 词：面神经 头颈肿瘤 面瘫 修复 舌下神经 小脑脑桥角 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]