吻合血管神经的MU展肌移植修复晚期面瘫.pdfVIP

through the upper lip to the unparalyzed facial side and anastomosed with facial vessels and one buccal branch of the Results Results facial nerve,individially.RReessuullttss Forty cases with long-standing facial palsy were treated with the treatment.All patients were followed up for more than 1 year.The face with a balanced position of oral commissure at rest,and a symmetrical and spontaneous smile were obtained in 23 cases.Other cases also obtained partial functional reconstruction of the Conclusions Conclusions affected faces in symmetry and active movement.CCoonncclluussiioonnssThe surgical procedure to reanimate facial palsy has some unique advantages,such as appropriate size and shape muscle,closely parallel alignment and unvaried anatomy of main vessels and nerve distributing to the muscle,a long neurovascular pedicle,un-difficult surgical procedure and so on.It is one of the ideal treative method for reanimation of facial palsy. [Key words] [Key words] [[KKeeyywwoorrddss]]Fcial paralysis;Abductor hallucis；Microvascular anastomosis Department of Plastic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003 (JIANG Hua, ZHAO Yao-Zhong, WU Hong, ZHANG Jian-Lin, SUN Mei-Qing) Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, （ GUO En-tan, ZHANG Ming-li, Ji Zheng-lun）。 面神经是临床上是最常受损伤的颅神经。一旦发生面神经麻痹，将导致面部表情肌的瘫痪和相应的颜面部畸形。 由于面神经的病损部位、病因、病程和畸形程度千差万别，由此衍生的治疗方法很多。吻合血管神经的骨骼肌移植一 直被推崇为重建晚期面瘫功能和形态比较符合生理、疗效较好的治疗方法。常用于移植重建面部功能和形态的供肌包 1 括，伸趾短肌、股薄肌、背阔肌、胸小肌和 MU 展肌 。作者自 1990 年来取用 MU 展肌做吻合血管神经的移植治疗病人 40 例，取得了较好的疗效。现将有关工作作一总结报告。 应用解剖 面神经是以运动神经纤维为主的混合神经，于桥脑下缘穿出，经内耳门入内听道，经过颞骨岩部的面神经管，由 茎乳孔出颅，穿过腮腺实质，分布于面部表情肌。出茎乳孔时主干直径为 1.5－2.0mm。