显微外科手术治疗创伤性舌下神经损伤的疗效分析  

Microsurgical treatment for traumatic hypoglossal nerve injury

作　　者：邓伟[1] 黄代营[2] 符良斌[1] DENG Wei;HUANG Dai-ying;FU Liang-bin(Department of Oral and Maxillofacial Surgery,Hainan General Hospital,Haikou,Hainan 570001,China)

机构地区：[1]海南省人民医院口腔颌面外科,海南海口570001 [2]中山大学附属第一医院口腔颌面外科,广东广州510080

出　　处：《中国临床研究》2020年第4期482-484,共3页Chinese Journal of Clinical Research

基　　金：国家自然科学基金(81360172)。

摘　　要：目的探讨显微外科手术治疗创伤性舌下神经损伤的疗效及临床价值。方法回顾性分析海南省人民医院及中山大学附属第一医院口腔颌面外科2009年1月至2016年12月收治的2例颌面外伤和2例医源性因素所致的舌下神经损伤患者的临床资料。给予经颌面部创口或颌下切口行显微外科手术修复舌下神经损伤,其中采取神经端端吻合修复3例,采取耳大神经移植修复1例。对其中合并舌神经损伤的1例,同期行舌神经端端吻合修复;对合并下颌骨骨折的1例,同期行下颌骨骨折切开复位坚强内固定术。结果4例创伤性舌下神经损伤患者治疗后均获得了良好的效果,术后3个月患者均自觉舌运动改善明显,1年后3例患者伸舌偏斜症状基本恢复正常,1例患者伸舌仍有轻度偏斜,但自觉舌运动及语言等改善明显。合并舌神经损伤同期治疗后舌感觉基本正常,合并下颌骨骨折患者术后咬合关系恢复正常。结论显微外科手术修复创伤性舌下神经损伤可获得良好的效果。Objective To explore the clinical efficiency and value of microsurgery for traumatic injury to the hypoglossal nerve.Methods A retrospective analysis was made on the clinical data of 4 cases of hypoglossal nerve injury,including 2 cases from maxillofacial trauma and 2 cases caused by iatrogenic factors from January 2009 to December 2016.The microsurgery through maxillofacial incision or submaxillary incision was performed to repair the hypoglossal nerve,in which 3 cases were repaired by end-to-end neurorrhaphy,and 1 case was repaired by transplantation of great auricular nerve.For one case with lingual nerve injury,the end-to-end anastomosis of lingual nerve was conducted at the same time,and for another case combined with mandibular fracture open reduction and rigid internal fixation was performed simultaneously.Results Four patients achieved good results after treatment.At three months after operation,the patients were conscious of the improvement of tongue movement.One year later,deviation of tongue extension basically returned to normal in three patients;one patient still had slight deviation of tongue extension,however,the tongue movement and language were obviously improved.For the patient with lingual nerve injury and the patient with mandibular fracture,the sense of tongue and the occlusal relationship return to normal after operation,respectively.Conclusion Microsurgical repair for traumatic hypoglossal nerve injury can achieve good results.

关 键 词：舌下神经 创伤 显微外科 神经损伤 神经修复 

分 类 号：R651.3[医药卫生—外科学]