CAJ | 학술논문

背景:面神经损伤不但给患者遗留不同程度的面神经麻痹(简称面瘫)畸形,还给患者带来生理缺陷和社会心理影响,尽可能早的进行损伤面神经修复、重建面神经功能成为目前临床研究的重点.目的:探讨创伤性面瘫手术时机和手术方法的选择,为创伤性面瘫的治疗和功能预后评估提供依据.设计:以患者为研究对象的病例分析.单位:中国协和医科大学整形外科医院.对象:1993-12/2001-11中国医学科学院中国协和医科大学整形外科医院南三病区收治创伤性面瘫患者9例.方法:对收治的9例创伤性面瘫患者,于伤后三四个月采用显微外科技术行面神经吻合及腓肠神经移植眼轮匝肌植入术修?回顾性总结并分析创伤性面瘫患者的临床资料.主要观察指标:采用House-Brackmann方法和手术前后面部摄影观察,评价创伤性面瘫患者面神经功能的恢复情况.结果:9例患者手术后临床随访6个月～2年,均获得了比较满意的面肌功能恢复.结论:创伤性面瘫,争取尽早手术是成功的关键,方法宜首选面神经吻合,神经移植肌肉内植入术对整复某些创伤性面瘫有其临床应用价值和适应证.强调神经外瘢痕松解切除、结合神经损伤的程度和形态特点,针对性选择面神经修复方法尤为重要.
배경:면신경손상불단급환자유류불동정도적면신경마비(간칭면탄)기형,환급환자대래생리결함화사회심리영향,진가능조적진행손상면신경수복、중건면신경공능성위목전림상연구적중점.목적:탐토창상성면탄수술시궤화수술방법적선택,위창상성면탄적치료화공능예후평고제공의거.설계:이환자위연구대상적병례분석.단위:중국협화의과대학정형외과의원.대상:1993-12/2001-11중국의학과학원중국협화의과대학정형외과의원남삼병구수치창상성면탄환자9례.방법:대수치적9례창상성면탄환자,우상후삼사개월채용현미외과기술행면신경문합급비장신경이식안륜잡기식입술수?회고성총결병분석창상성면탄환자적림상자료.주요관찰지표:채용House-Brackmann방법화수술전후면부섭영관찰,평개창상성면탄환자면신경공능적회복정황.결과:9례환자수술후림상수방6개월～2년,균획득료비교만의적면기공능회복.결론:창상성면탄,쟁취진조수술시성공적관건,방법의수선면신경문합,신경이식기육내식입술대정복모사창상성면탄유기림상응용개치화괄응증.강조신경외반흔송해절제、결합신경손상적정도화형태특점,침대성선택면신경수복방법우위중요.
BACKGROUND: Facial nerve injury causes facial nerve paralysis (or facial palsy) and even results in psychosocial disturbances of the patients. Repair the injured facial nerve and reconstruction of the nerve function as early as possible have been the primary concern in clinical studies.OBJECTIVE: To investigate the timing and surgical approaches for repairing facial paralysis in order to provides evidences for its therapeutic and prognostic evaluation.DESIGN: Case analysis based on patients.SETTING: Hospital of Plastic Surgery of Chinese Academy of Medical Sciences.PARTICIPANTS: Nine patients with traumatic facial paralysis hospitalized in the Hospital of Plastic Surgery of Chinese Academy of Medical Sciences from December 1993 to November 2001.METHODS: Facial nerve anastomosis was performed microsurgically along with the implantation of the sural nerve graft into orbicular muscle of the eye 3 or 4 months after nerve injury in the 9 patients. The clinical data of the patients were retrospectively reviewed.MAIN OUTCOME MEASURES: The facial nerve function was evaluated with House-Brackmann scale and photographs of the patients' faces before and after surgical treatment were taken.RESULTS: In the follow-up of these patients lasting 6 months to 2 years,all the patients attained satisfactory outcome.CONCLUSION: Early operation is crucial for the treatment of traumatic facial paralysis,with facial nerve anastomosis as the primary choice. The implantation of the nerve graft into muscle is also indicated for repairing traumatic facial paralysis in some cases. The importance of individualized treatment choice is reiterated on the basis of cicatrectomy and the extent and specific features of the injury.