腮腺切除保留面神经手术后的面神经核超微结构变化的观察

Study of Facial never and Neuronal Soma after Paratldectomy Without Facial Never in Rabbit

目的:手术显微镜下行腮腺全切同时保留面神经,采用保护面神经外血管系及破坏面神经外血管系两种术式,研究其相关神经元胞体超微结构的病理变化。方法:选用健康家兔,采用本体对照方法,模拟人腮腺全切术。实验侧手术显微镜下腮腺全切,解剖面神经,保护面神经外血管系;对照侧镜下完成相同手术,但破坏神经外血管系。15只兔分为三组,术后2、3、4周分别取面神经核电镜下观察其超微结构的病理变化。结果:术后4周实验侧面神经核内各种细胞形态正常;对照侧面神经核内线粒体变性、溶酶体明显增多,大部分细胞器失去正常结构。结论:手术显微镜下解剖面神经切除腮腺,保护面神经外血管系可避免或减轻因神经局部缺血造成神经核细胞逆行性变性所致的面瘫发生。

Objective： To analyse the pathological state of neuronal soma of facial nerve after parotidectomy without facial nerve in rabbit. Methods： Health rabbits were collected for the parotidectomy as that of on The same rabbit. Capillary net on the facial nerve were protected from damaging on the experimented side when excising parotid glands and dissecting facial nerve by surgical microscope. The same operation were performed on the control side,however, the capillary net on it were completely destructed. Fifteen rabbits were divided into three groups. The neuronal soma of Facial nerve in brain were stained and observed under electron microscope at 2,3,4 weeks after parotidectomy. Results： At 5 week after operation the neuronal soma of facial nerve were normal on the experimented sides, but the degenerated mitochondrian and dissolved nissl body were easily observed on the other sides. Conclusion： The study indicated that morbidity of facial paralysis descend because of the protected capillary net on the facial nerve , which decreased degeneration and necrosis of the nerve fibres, and degeneration of neuronal soma.