舌下神经颏舌肌蒂植入失神经胸大肌瓣的实验研究

An experimental study of reinnervation of denevated pectoralis myoflap by hypoglossal-genioglossus muscle neuromuscular pedicle transplantation

目的 :探讨失神经胸大肌瓣重获神经支配的新方法。方法 :在 2 0只新西兰白兔胸大肌瓣转移的动物模型上 ,进行原神经支配和失神经后舌下神经颏舌肌蒂植入神经再支配的比较。术后 4、8、12、16周行大体观察、光镜观察、激发肌电、神经免疫组化、肌纤维酶组织化学染色的肌纤维组化分型检查。结果 :失神经胸大肌瓣可重获舌下神经再支配 ,并在舌下神经支配下行使收缩功能 ,肌纤维的组化型别发生改变 ,从以酵解型纤维为主转化为以氧化型纤维为主 ,呈镶嵌分布模式 ,而类似舌下神经原支配的肌肉。结论 :舌下神经颏舌肌蒂植入能使失神经胸大肌瓣重新获得良好的神经再支配。

砄bjective: To seek for the method of reinnervation of denervated pectoralis major myoflap. Method:The model of pectoralis major myoflap transposition in 20 New Zealand rabbits was used. After the myoflaps were transferred (original nerve innervation,ON) and ON denervation followed by hypoglossal genioglossus muscle neuromuscular pedicle implantation (NMP) wre performed. The flaps were examined at the intervals of 4,8,12 and 16 weeks respectively after operation. Results:In NMP myoflaps contracted when the hypoglosal nerve was stimulated,some type Ⅱ fibers in the myoflaps transformed into type I, but the pattern of distribution of the muscle fibers displayed mosaic and was similar to that of genioglossus muscle. Conclusion:The denervated pectoralis major myoflap can be reinnervated by hypoglossal-genioglossus muscle neuromuscular pedicle transplantation.