人工室修复颞骨内面神经缺损后神经再支配的实验研究(英文)  

Functional test of regenerated rabbit intratemporal facial nerve in man-made chamber

作　　者：蔡萍[1] 刘公汉[1] 华清泉[1] 吴展元[1] 肖伯奎[1] 

机构地区：[1]武汉大学人民医院耳鼻咽喉-头颈外科,湖北省武汉市430060

出　　处：《中国临床康复》2003年第13期1906-1907,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的通过测试再生神经及肌肉的功能,探讨人工室修复颞骨内面神经缺损后神经再支配情况。方法选用48只成年大耳白兔,以随机数字表法分成2组,横断左侧颞骨内面神经,神经近远端分别用几丁质管和硅胶管桥接,术后1月、3月和5月进行面部行为学观察以及电生理检查。结果两种人工室5月组比3月组睑裂缩小、上唇自发运动有力、叩鼻后长须更明显偏向外侧、电极刺激神经后面肌收缩剧烈。术后3月,几丁质组(Ch)和硅胶组(Si)与正常(N)比较,两组神经诱发电位的潜伏期(IP)较长、动作电位波幅(AMP)较低,神经-肌肉传导速度(NMCV)较慢,有显著性差异(F=72.93-95.16,P<0.01)。术后5月,差距减小,但仍有显著性差异(F=4.144-5.773,P<0.05)。神经电生理显示随着修复时间的延长,潜伏期逐渐缩短,动作电位波幅逐渐增高,神经—肌肉传导速度逐渐增快,两种人工室之间无显著性差别。结论人工室修复颞骨内面神经缺损神经肌肉功能恢复良好,肌肉重获神经再支配。Aim To investigate the reinnervation by testing the function of regenerated intratemporal facia l nerve and muscle when using man-mad e chamber as a bridge in the repair of in tratemporal facial nerve defect.Methods In 48adult Japanese large ear white r abbits,an unilateral 6mm intratemporal facial nerve gap was c reated ,and the proximal and distal stumps were inserted into chitin tube and silicone tube respectively.The white rabbits were divided into two g roups by random .At one month,three months and five months postoperativ ely,four facial behavioral observations and one electrophysiological study were performed.Rusults The facial behaviors including size of palpebr al fissure,upper-lip spontaneous move-ment,whisker deviation following a midline nasal tap and muscle contrac-tion of the quadratus labii superioris muscle following intratemporal f acial nerve stimulation at five months postoperatively were all better than th at at three months postoperatively in two different kinds of chambers.Compared to normal nerve,the regenerating nerves in both the chitin tube-bridged group and the silicone tube-bridged group had longer incubation period,lower amplitude and slower nerve-mu scle conduction velocity at three months postoperatively .The differences were statistically significa nt (F=72.93-95.16,P<0.01).At five months postoperatively,th e differ-ences were decreased but were still s tatistically significant (F=4.144-5.773,P<0.05).Nerve evoked potential response sh owed that with the progress of regeneration,the incubation period became shortened,the a m-plitude of action potential was increased and nerve-muscle conduction v e-locity was quickened.There was no significant difference between two ki nds of chambers.Conclusion The functions of regenerated facial nerve and innervated muscles after nerve tran section could recover in two differe nt kinds of man-made chambers.

关 键 词：人工室 修复 颞骨内面神经缺损 神经再支配 实验 功能测试 面神经疾病 兔 

分 类 号：R651.3[医药卫生—外科学]