中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2013年
4期
354-357
,共4页
面神经%面瘫%舌下神经%神经吻合
麵神經%麵癱%舌下神經%神經吻閤
면신경%면탄%설하신경%신경문합
Facial nerve%Facial paralysis%Hypoglossal nerve%Nerve anastomosis
目的 探讨舌下-面神经吻合术治疗前庭神经鞘瘤术后面瘫的效果、策略和显微外科技巧.方法 回顾性分析16例行舌下-面神经吻合术患者的临床和随访资料.结果 舌下-面神经吻合术与肿瘤切除的时间间隔为1-13个月(平均7.6个月).术前面神经功能House-Brackmann分级Ⅵ级13例,Ⅴ级3例.术后Ⅱ级2例,Ⅲ级10例,Ⅳ级4例；15例患者闭眼能力恢复理想,恢复了静态时面部对称性和某些随意运动.结论 舌下-面神经吻合术是一种行之有效的治疗手段,手术时机的把握和显微外科操作技术是取得满意临床效果和提高患者生活质量的保证.
目的 探討舌下-麵神經吻閤術治療前庭神經鞘瘤術後麵癱的效果、策略和顯微外科技巧.方法 迴顧性分析16例行舌下-麵神經吻閤術患者的臨床和隨訪資料.結果 舌下-麵神經吻閤術與腫瘤切除的時間間隔為1-13箇月(平均7.6箇月).術前麵神經功能House-Brackmann分級Ⅵ級13例,Ⅴ級3例.術後Ⅱ級2例,Ⅲ級10例,Ⅳ級4例；15例患者閉眼能力恢複理想,恢複瞭靜態時麵部對稱性和某些隨意運動.結論 舌下-麵神經吻閤術是一種行之有效的治療手段,手術時機的把握和顯微外科操作技術是取得滿意臨床效果和提高患者生活質量的保證.
목적 탐토설하-면신경문합술치료전정신경초류술후면탄적효과、책략화현미외과기교.방법 회고성분석16례행설하-면신경문합술환자적림상화수방자료.결과 설하-면신경문합술여종류절제적시간간격위1-13개월(평균7.6개월).술전면신경공능House-Brackmann분급Ⅵ급13례,Ⅴ급3례.술후Ⅱ급2례,Ⅲ급10례,Ⅳ급4례；15례환자폐안능력회복이상,회복료정태시면부대칭성화모사수의운동.결론 설하-면신경문합술시일충행지유효적치료수단,수술시궤적파악화현미외과조작기술시취득만의림상효과화제고환자생활질량적보증.
Objective To evaluate the results of hypoglossal-facial nerve anastomosis (HFA) for facial paralysis following vestibular schwannoma surgery,and to discuss the surgical techniques.Methods A retrospective study of 16 consecutive cases who underwent HFA operation between January 2000 and January 2010 was done.All the patients had undergone surgery for excision of vestibular schwannomas and had suffered facial paralysis as a consequence of this procedure.Classical end-to-end HFA was performed in all cases,and in 9 cases the classical HFA is combined with an anastomosis of the descending branch of the hypoglossal nerve to the distal stump of the same hypoglossal nerve.The pre-and postoperative facial nerve function of all patients was evaluated with the House-Brackmann (HB) grading.Results There were 9 female and 7 male patients with a mean age of 42.5 years (Range 31 ～ 61 years).The mean time interval between tumoral and reparative surgery was 7.6 months (Range 1-13 months).The preoperative HB grades were Ⅵ in 13 patients,Ⅴ in 3 patients.In the majority of the cases the first sign of reinnervation were detected between 3 and 6 months after surgery.All but one patient recovered facial muscle tone and some voluntary movement and exhibited complete restoration of facial symmetry at rest and regained complete voluntary eye closing ability.The final HB grades were Ⅱ in 2 patients,Ⅲ in 10 patients and Ⅳ in 4 patients.Conclusions HFA is a useful procedure for facial reanimation and can produce good clinical results as well as leading to an improvement in the quality of life in patients with facial paralysis.
