CAJ | 학술논문

目的探讨改良的舌下神经-面神经端-侧吻合术修复不完全性面瘫的治疗效果.方法 28只大鼠分为6组,A组:健康对照组,不做任何处理;B组:完全性面瘫组,完全离断面神经后不做任何处理;C组:不完全性面瘫组,损伤结扎面神经后不做任何处理;D组:不完全面瘫修复组,术后4个月离断神经移植物;E组:不完全面瘫修复组,术后4个月离断面神经近侧端.鼻尖偏离指数实验检测面容对称性;神经电生理检测肌动作电位;逆行示踪法检测舌下神经的再生;半薄切片观察髓鞘再生.结果鼻尖偏离指数实验检测α角度,D组比C组β角恢复明显(P＜0.01);肌动作电位检测D组的峰面积值明显高于C组(P＜0.01).半薄切片显示D组面神经远端内新生髓鞘的数量多于C组(P＜0.01).逆行示踪显示,在修复术后4个月,D组大鼠的面神经核和舌下神经核中检测到(284±80)个和(83±48)个CTB-Alexa55标记的神经元.结论利用预变性腓浅神经移植物桥接舌下神经和面神经这个改良的吻合术修复不完全性面瘫,能够明显改善不完全损伤的面神经功能,有效治疗不完全性面瘫.
목적 탐토개량적설하신경-면신경단-측문합술수복불완전성면탄적치료효과.방법 28지대서분위6조,A조:건강대조조,불주임하처리;B조:완전성면탄조,완전리단면신경후불주임하처리;C조:불완전성면탄조,손상결찰면신경후불주임하처리;D조:불완전면탄수복조,술후4개월리단신경이식물;E조:불완전면탄수복조,술후4개월리단면신경근측단.비첨편리지수실험검측면용대칭성;신경전생리검측기동작전위;역행시종법검측설하신경적재생;반박절편관찰수초재생.결과 비첨편리지수실험검측α각도,D조비C조β각회복명현(P＜0.01);기동작전위검측D조적봉면적치명현고우C조(P＜0.01).반박절편현시D조면신경원단내신생수초적수량다우C조(P＜0.01).역행시종현시,재수복술후4개월,D조대서적면신경핵화설하신경핵중검측도(284±80)개화(83±48)개CTB-Alexa55표기적신경원.결론 이용예변성비천신경이식물교접설하신경화면신경저개개량적문합술수복불완전성면탄,능구명현개선불완전손상적면신경공능,유효치료불완전성면탄.
Objective For the treatment of persistent incomplete facial palsy,we investigated in rats a modified method using hypoglossal-facial nerve "side"-to-side neurorrhaphy with predegenerated nerve graft(PNG).Methods 28 adult male Fisher 344 rats were grouped into A (intact),B (complete facial palsy),C (incomplete facial palsy),D (incomplete facial palsy repair-cut PNG) and E (incomplete facial palsy repair-cut facial nerve).The treatment was assessed by the angle α analysis,electrophysiological examination,electron microscopy analysis and retrograde labeling.Results The group D was found a higher recovery of facial symmetry compared to group C (P ＜ 0.01).MAPs displayed significantly greater surface values in group D compared with group C (P ＜ 0.01).The analysis of semithin sections in distal facial nerve showed numerous regenerating myelinated axons (P ＜ 0.01).There were 83 ±48 and 284 ± 80 CTB Alexa 555 labeled neurons in group D,respectively,in the right hypoglossal and facial nuclei 4 months after hypoglossal-facial nerve neurorrhaphy.Conclusions This study demonstrated that hypoglossal-facial nerve "side"-to-side neurorrhaphy through a predegenerated nerve graft could lead to rapid functional benefits for persistent incomplete facial palsy.