耳大神经移植在面神经颅外分支缺损即刻修复的临床效果  

Clinical efficacy of immediate reconstruction of extracranial facial nerve branch defects through transplantation of great auricular nerve

作　　者：魏景健[1] 郑浩[1] 张爱侠[1] 韩琨[1] 李晓东 孟箭[1] 马芬芬[2] Wei Jingjian;Zheng Hao;Zhang Aixia;Han Kun;Li Xiaodong;Meng Jian;Ma Fenfen(Department of Stomatology,Xuzhou Central Hospital,Xuzhou Medical University Clinical School,Xuzhou 221009,China;Department of Medical Ultrasound,Xuzhou Central Hospital,Xuzhou Medical University Clinical School,Xuzhou 221009,China)

机构地区：[1]徐州市中心医院、徐州医科大学徐州临床学院口腔科,徐州221009 [2]徐州市中心医院、徐州医科大学徐州临床学院超声医学科,徐州221009

出　　处：《中华医学美学美容杂志》2025年第1期36-41,共6页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：国家口腔疾病临床医学研究中心开放课题(NCRCO-202101);徐州市科技项目(KC23172)。

摘　　要：目的:观察耳大神经移植在面神经颅外分支缺损即刻修复的临床效果。方法:回顾性纳入2021年6月至2023年1月徐州市中心医院口腔科因腮腺恶性肿瘤和神经源性肿瘤导致面神经颅外分支缺损患者17例,其中男10例,女7例,年龄28~68(42.4±11.4)岁。患者均于术中同期行耳大神经即刻移植术。根据末次随访的House-Brackmann(HB)面瘫分级标准进行面神经功能评估,Ⅰ~Ⅲ级为有效,Ⅳ~Ⅵ级为无效。采用躯体功能评分(FDIP)及社会功能评分(FDIS)进行生活质量评价。结果:术后随访6~30(18.3±6.6)个月,面神经功能HB面瘫分级Ⅰ级4例,Ⅱ级6例,Ⅲ级4例,Ⅳ级3例,面神经功能修复有效率为14/17。末次随访时FDIP评分为(84.7±9.1)分,高于修复即刻的(54.1±20.6)分(P<0.001);FDIS评分为(11.8±8.9)分,低于修复即刻的(57.5±11.7)分(P<0.001)。结论:耳大神经移植即刻修复面神经颅外分支缺损可有效改善面神经功能,提高生活质量。ObjectiveTo observe the clinical efficacy of immediate repair of extracranial branch defects in the facial nerve through transplantation of the great auricular nerve.Methods A retrospective inclusion was carried out on 17 patients with extracranial branch defects of the facial nerve caused by parotid malignant tumors and neurogenic tumors in the Department of Stomatology of Xuzhou Central Hospital from June 2021 to January 2023,including 10 males and 7 females,with the age ranged from 28 to 68(42.4±11.4)years old.All patients underwent immediate transplantation of the greater auricular nerve during the operation.The facial nerve function was evaluated according to the House-Brackmann(HB)facial paralysis grading standard at the last follow-up.Grade Ⅰ-Ⅲ was considered effective,and grade Ⅳ-Ⅵ was considered ineffective.The quality of life was evaluated using the physical function score(FDIP)and social function score(FDIS).Results The follow-up time was 6-30(18.3±6.6)months.The facial nerve function was classified as gradeⅠin four cases,grade Ⅱ in six cases,grade Ⅲ in four cases,and grade Ⅳ in three cases.This resulted in an effective rate of 14/17.The FDIP score at the final follow-up was(84.7±9.1)points,which was higher than the(54.1±20.6)points recorded at the immediate moment of repair(P<0.001).In contrast,the FDIS score was(11.8±8.9)points,which was lower than the(57.5±11.7)points recorded at the immediate moment of repair(P<0.001).Conclusion The transplantation of the auricular great nerve can effectively enhance facial nerve function and improve the life quality in the immediate repair of defects in the extracranial branches of the facial nerve.

关 键 词：面神经 耳大神经 面神经缺损 即刻修复 神经移植 

分 类 号：R73[医药卫生—肿瘤]