带胸锁乳突肌瓣的耳大神经移植在面神经缺损修复中的应用

Application of sternocleidomastoid muscle-great auricular nerve flap in repair of facial nerve defect

目的 :探讨腮腺癌切除面神经即刻功能性修复的新方法。方法 :采取带胸锁乳突肌瓣的耳大神经移植的方法 ,对腮腺癌根治术切除面神经造成神经缺损即刻修复 ,与单纯利用耳大神经游离移植的修复方法进行比较。结果 :带胸锁乳突肌瓣的耳大神经移植的方法 ,面神经功能的恢复率为 92 3% ,面神经功能恢复时间平均为 2 1.5周 ;单纯利用耳大神经游离移植的修复方法 ,面神经功能的恢复率仅为 5 4 3% ,面神经功能恢复时间平均为 36 .4周。两方法差异显著 (P<0 .0 5 ) ;腮腺区手术后的凹陷畸形得到修复。结论 :带胸锁乳突肌瓣的耳大神经移植能有效恢复面神经功能 ,缩短面神经功能恢复时间 ,既实现了功能性修复又达到了面部外形的改善 ,临床效果比较理想。

Objective: To study a new clinical method of functional repair of facial nerve in parotidectomy of parotid carcinoma. Methods:Transplantation of sternocleidomastoid muscle-great auricular nerve flap was used to repair defect of facial nerve in parotidectomy. Results: In patients underwent transplantation of sternocleidomastoid muscle-great auricular nerve flap,the ratio of recovery of facial function was 92.3% and average time of recovery was 21.5 weeks. In those underwent transplantation of great auricular nerve,the ratio was 54.3% and the time was 36.4. The difference between these 2 methods was significant (P<0.05). The depressed deformity was corrected. Conclusion: With transplantation of sternocleidomastoid muscle-great auricular nerve flap,time of facial function recovery is shortened. The method can not only accomplish functional repair but also correct facial deformity.