中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2022, Vol. 17 ›› Issue (5): 1125-1130.doi: 10.4103/1673-5374.324862

• 原著:退行性病与再生 • 上一篇    下一篇

长段面神经修复及咬肌神经转位对面神经中枢端损伤的早期修复：回顾性比较研究

  

  • 出版日期:2022-05-15 发布日期:2021-11-22

Facial reanimation with interposition nerve graft or masseter nerve transfer: a comparative retrospective study

Wen-Jin Wang1, #, Wei-Dong Zhu2, 3, 4, #, Mathias Tremp5, #, Gang Chen1, Zhao-Yan Wang2, 3, 4, *, Hao Wu2, 3, 4, *, Wei Wang1, *   

  1. 1Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; 2Department of Otolaryngology Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; 
    3Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China; 4Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China; 5Department of Plastic, Reconstructive, Aesthetic and Handsurgery, University Hospital Basel, Basel, Switzerland
  • Online:2022-05-15 Published:2021-11-22
  • Contact: Wei Wang, MD, PhD, prsdavidwang@163.com; Hao Wu, MD, PhD, wuhao622@sina.com; Zhao-Yan Wang, MD, PhD, wzyent@126.com.
  • Supported by:
    This study was supported by Shanghai Municipal Commission of Health and Family Planning Program, China, No. 201504253 (to WW); Special Fund for Science and Technology Innovation by Shanghai Jiao Tong University, China, No. YG2016MS10 (to WW); the National Natural Science Foundation of China, Nos. 81570906 (to HW) and 81371086 (to ZYW). 

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摘要：

在面神经发生不可逆损伤后，长段面神经修复及咬肌神经转位均已成功应用于其修复，但是到目前为止尚无这2种方法的比较研究。此次两中心双臂回顾性病例分析研究纳入了2003至2006年在上海交通大学医学院附属耳科研究所使用长段面神经修复面神经切除或创伤患者（n=17，男8例，女9例，年龄42.1岁）以及2010年11月至2016年2月在上海第九人民医院进行咬肌神经转位修复面神经损伤的患者（n=15，男6例，女9例，年龄40.6岁）。结果发现，咬肌神经转位修复的患者House-Brackmann III级的比例（15/15）多于长段面神经修复患者（12/17）。同时咬肌神经转位修复的患者的口腔连合偏移率也高于长段面神经修复患者。提示咬肌神经转位修复能够促进更好地神经恢复及口角活动，并且能够避免严重两端的出现，但长段神经移植对静态对称性的维持似乎有更好的效果。研究已于2019年12月12日经上海市第九人民医院伦理委员会批准，批准号SH9H-2019-T332-1。

https://orcid.org/0000-0002-6398-5172 (Wei Wang)

关键词: 面瘫, 面神经修复, 神经转位, 咬肌, 突触, 静态对称性, 口腔连合偏移, House-Brackmann评分, 面部对称性

Abstract: Both interposition nerve grafts and masseter nerve transfers have been successfully used for facial reanimation after irreversible injuries to the cranial portion of the facial nerve. However, no comparative study of these two procedures has yet been reported. In this two-site, two-arm, retrospective case review study, 32 patients were included. Of these, 17 patients (eight men and nine women, mean age 42.1 years) underwent interposition nerve graft after tumor extirpation or trauma between 2003 and 2006 in the Ear Institute, School of Medicine, Shanghai Jiao Tong University, China, and 15 patients (six men and nine women, mean age 40.6 years) underwent masseter-to-facial nerve transfer after tumor extirpation or trauma between November 2010 and February 2016 in Shanghai Ninth People’s Hospital, China. More patients achieved House-Brackmann III recovery after masseter nerve repair than interposition nerve graft repair (15/15 vs. 12/17). The mean oral commissure excursion ratio was also higher in patients who underwent masseter nerve transfer than in patients subjected to an interposition nerve graft. These findings suggest that masseter nerve transfer results in strong oral commissure excursion, avoiding obvious synkinesis, while an interposition nerve graft provides better resting symmetry. This study was approved by the Institutional Ethics Committee, Shanghai Ninth People’s Hospital, China (approval No. SH9H-2019-T332-1) on December 12, 2019. 

Key words: facial palsy, facial reanimation, facial symmetry, House-Brackmann score, interposition, masseter nerve, nerve graft, oral commissure excursion, resting symmetry, synkinesis

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