带神经血管肌束移植术在晚期面瘫修复中的应用

ABSTRACTCLINICAL USE OF TRANSPLANTATION OF FREE MUSCLE GRAFT WITH NEUROVAS-CULAR BUNDLE FOR TREATMENT OF LATE FACIAL PARALYSIS

在行吻合血管神经的游离肌肉移植术修复晚期面瘫的４６例中，选择有适应证的２８例行带神经血管的背阔肌肌束移植术。该术式对肌束形态的特殊设计，不仅能作为动力重建，恢复患侧口角活动，使口角呈动态对称，而且由于带神经血管肌束对尖神经肌肉有再神经化的作用，使口周及眼周多块失神经肌肉恢复神经支配及收缩功能，收到了以往手术未能达到的良好效果。详细介绍了手术适应证，手术方法及术后处理。讨论了对再生神经再教育的重要性及进行二期调整手术的必要。

sing transplantation of free muscle with microneurovascular anastomosis for 46 cases of latefacial paraiysis,we selected M. latissimus dorsi as neurovascularized musele bundle graft in 28 ofthem. This was not only an operation for facial dynamic reconstruction but also a new method forreinnervation of oral and ocular sphincter; After operation all of them revealed symmetry withvoluntary motions. The results were satisfactory.The indications for surgical treatment, the procedure, and the management after the treat-ment were discussed in details. The importance of re-education of the regenerating nerve and the necessity of two-staged operation were also discussed.