CAJ | 학술논문

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.
목적통과측시재생신경급기육적공능,탐토인공실수복섭골내면신경결손후신경재지배정황.방법선용 48지성년대이백토,이수궤수자표법분성 2조,횡단좌측섭골내면신경,신경근원단분별용궤정질관화규효관교접,술후 1월、 3월화 5월진행면부행위학관찰이급전생리검사.결과량충인공실 5월조비 3월조검렬축소、상진자발운동유력、고비후장수경명현편향외측、전겁자격신경후면기수축극렬.술후 3월,궤정질조 (Ch)화규효조 (Si)여정상 (N)비교,량조신경유발전위적잠복기 (IP)교장、동작전위파폭 (AMP)교저,신경-기육전도속도 (NMCV)교만,유현저성차이 (F=72.93- 95.16,P< 0.01).술후 5월,차거감소,단잉유현저성차이 (F=4.144- 5.773,P< 0.05).신경전생리현시수착수복시간적연장,잠복기축점축단,동작전위파폭축점증고,신경-기육전도속도축점증쾌,량충인공실지간무현저성차별.결론인공실수복섭골내면신경결손신경기육공능회복량호,기육중획신경재지배.
Aim To investigate the reinnervation by testing the function of regenerated intratemporal facial nerve and muscle when using man-made chamber as a bridge in the repair of intratemporal facial nerve defect. Methods In 48 adult Japanese large ear white rabbits, an unilateral 6 mm intratemporal facial nerve gap was created ,and the proximal and distal stumps were inserted into chitin tube and silicone tube respectively. The white rabbits were divided into two groups by random . At one month, three months and five months postoperatively, four facial behavioral observations and one electrophysiological study were performed.Rusults The facial behaviors including size of palpebral fissure, upper-lip spontaneous movement, whisker deviation following a midline nasal tap and muscle contraction of the quadratus labii superioris muscle following intratemporal facial nerve stimulation at five months postoperatively were all better than that 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-muscle conduction velocity at three months postoperatively . The differences were statistically significant (F=72.93- 95.16,P< 0.01). At five months postoperatively, the differences were decreased but were still statistically significant (F=4.144- 5.773,P< 0.05) . Nerve evoked potential response showed that with the progress of regeneration, the incubation period became shortened, the amplitude of action potential was increased and nerve-muscle conduction velocity was quickened. There was no significant difference between two kinds of chambers. Conclusion The functions of regenerated facial nerve and innervated muscles after nerve transection could recover in two different kinds of man-made chambers.