带神经血管股薄肌肌瓣治疗晚期面瘫中供体神经的选择  

The selection of donor nerves in the treatment of late facial paralysis with neurovascular gracilis muscle flap

作　　者：梁虹宇 李养群 Liang Hongyu;Li Yangqun(The Second Department 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,100144

出　　处：《中华整形外科杂志》2021年第7期817-822,共6页Chinese Journal of Plastic Surgery

基　　金：北京协和医学院2019年学科建设专项建设项目(2150019022)。

摘　　要：带神经血管蒂的股薄肌游离肌瓣已广泛应用于治疗晚期面瘫,手术成功的关键因素之一是选择合适的供体神经,选定的运动神经必须能提供足够强度的神经支配,以产生强有力的肌肉收缩,使患者能够自主控制肌肉的运动。为了实现面部对称和自发的活动,跨面神经移植被认为是理想的选择;在没有面神经的情况下,咬肌神经是较好的替代选择,可以提供高动力神经输入;近年来,有学者试图结合两种供体神经的优势进行双运动神经吻合,术后具有强大而协调的面部动态效果。该文对股薄肌游离肌瓣治疗晚期面瘫中供体神经的选择进行总结,认为每种方式各有其优缺点。The free functional gracilis flap with the neurovascular pedicle has been widely used in the treatment of late facial paralysis.One of the key factors in this process is the selection of the appropriate donor nerve.The selected motor nerve must be able to provide adequate innervation to produce strong muscle contraction and allow the patient to control the movement of the muscle autonomously.To achieve synchronous and spontaneous activity,cross-facial nerve graft is considered to be an ideal choice.In the absence of facial nerve,masseteric nerve is a good alternative,which can provide high dynamic nerve input.Recently,dual motor nerve transplantations attempt to combine the advantages of the two donor nerves,with powerful and coordinated facial dynamic effects.In this manuscript,the selection of donor nerve in the treatment of late facial paralysis with free functional gracilis transfer was summarized.Advantages and disadvantages of each method were analyzed.

关 键 词：外科皮瓣 股薄肌 面神经麻痹 移植 

分 类 号：R651.3[医药卫生—外科学]