失神经支配后面肌结构变化与面肌功能恢复的相关性(英文)

Correlation between structural changes of facial muscle after denervation and rehabilitation of facial muscle function

背景:模仿颞骨创伤性面神经麻痹,制作面神经麻痹模型,研究神经肌肉在组织病理学方面的变化及其对面肌功能恢复的影响有重要意义。目的:探讨不同程度面神经失神经支配后口轮匝肌线粒体结构和琥珀酸脱氢酶(succinatedehydrogenase,SDH)的变化与面肌功能恢复关系。设计:以动物为研究对象,随机对照实验研究。单位:一所大学医院的耳鼻咽喉科。材料:实验在中国医科大学实验动物部,基础医学院组织胚胎学教研室,第二电镜室进行。实验动物为白色豚鼠60只,由中国医科大学实验动物部犤许可证号:SCXK(辽)2003-0009犦提供,随机分成3组,压榨面神经总干5s组(n=15,其中10只进行功能学测试,手术后15s5只取材制备电镜标本),15s组(n=20,其中10只进行功能学测试,手术后15d和30d分别取5只制备电镜标本)和30s组(n=25,其中10只进行功能学测试,手术后15d和30d分别取5只和10只制备电镜标本)。干预:制造面神经麻痹模型,应用神经电图(EN0G)测试压榨面神经前后最小反应阈值,应用瞬目反射观察面肌功能恢复时间。取口轮匝肌进行SDH酶细胞化学染色,透射电镜下观察SDH阳性反应颗粒,线粒体和肌纤维超微结构变化。主要观察指标:压榨面神经前后EN0G阈值,面肌功能恢复时间,SDH阳性反应颗粒,线粒体和肌纤维超微结构变化。结果:压榨面神经5s组?

BACKGROUND:It is of significance to imitate facial nerve paralysis of temporal trauma,establish the model of facial nerve paralysis, and study the histopathologic changes of facial muscle after denervation and the effect on rehabilitation of facial muscle function. OBJECTIVE:To investigate the relationship between rehabilitation of facial muscle function and the structural changes of mitochondria and succinate dehydrogenase(SDH) of oris muscles after denervation. DESIGN:A randomized controlled trail based on experimental animals. SETTING:Department of otolaryngology in a hospital of a university. MATERIALS:The experiments were conducted in the Center of Animal Experiment,the Department of Histoembryology, and the Second Electron Microscope(EM) Center, China Medical University.Sixty white guinea pigs provided by the Center of Animal Experiment,China Medical University [certification No: SCXK(liao) 2003-0009],were randomly divided into three groups,5 s squeezed group(n=15,10 tested for the function of facial muscle,5 for EM specimen 15 days after operation),15 s squeezed group(n=20,10 tested,5 for EM specimen 15 days and 30 days after operation),and 30 s squeezed group(n=25, 10 tested,5 for EM specimen 15 days after operation and 10 for EM specimen 30 days after operation). INTERVENTIONS:Models of facial paralysis were established.The threshold of facial nerve was detected with electroneurogram(ENoG) before and after squeezed,and the duration of the functional recovery of facial muscle was observed with blink reflex.Orbicularis oris was taken for SDH cytochemical staining,and the ultrastructural changes of SDH positive reaction granules,mitochondria and muscle fibers were observed under transmission electroscope. MAIN OUTCOME MEASURES:ENoG threshold value,time for recovery of facial muscle function,SDH positive reaction granules and ultrastructural changes of mitochondria and muscle fibers. RESULTS:In 5 s squeezed group,the average inhibition time of nerve excitement conduction was(35.2±16.8) minutes,the structure of mitochondria and the positive reaction granules of SDH remained normal,and the muscle fiber had no pathologic changes.In 15 s squeezed group,it took an average of(47±15) days for blink reflect to recover.In 15 s squeezed group of 15 days,the mitochondria showed slight bubble degeneration and the SDH granules decreased and the muscle fiber had slight pathologic changes,but recovered after 30 days.The mitochondria changed severely and SDH granules decreased significantly in 30 s squeezed group of 15 days and 30 days;no case of blink reflect recovered within half a year. CONCLUSION:The longer the facial nerve is injured,the more severely the function of facial muscles is damaged,and the more difficultly it will recover.Therefore,facial nerve decompression should be performed as early as possible.