选择性手术显微镜下腮腺切除减少面瘫发生的实验研究

Experimental study on reducing the morbidity of the facial paralysis after parotidectomy by selective microsurgery

目的 探讨保护神经外血管系 ,减少神经局部缺血造成面神经核细胞逆行性变性所致面瘫的途径。 方法 选用健康家兔 ,采用自体对照方法 ,模拟人腮腺全切术。实验侧在手术显微镜下游离面神经切除腮腺 ,保护神经外血管系。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周分别取面神经核光镜下观察。 结果 实验侧术后面瘫症状轻微 ,发生率低。对照侧面瘫显著。术后 4周对照侧面神经核细胞数少于实验侧 (P <0 .0 5 )。 结论 手术显微镜下解剖面神经切除腮腺 ,保护外血管系 ,可减少因神经局部缺血造成的面瘫。

Objective To reduce the morbidity of facial paralysis because of ischemia of the facial nerve led to retrograde degeneration of the neuronal soma. Methods Health rabbits were collected for the parotidectomy as that of on the same rabbit. Capillary net on the facial never were protected from damaging on the experiment side when excising parotid glands and dissecting facial never 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 ficial nerve in brain tissue were stained and observed under optic microscope at 2,3,4 weeks after operation. Results Both of symptom and morbidity of the facial paralysis on the experiment side were lower than that on the control sides. The number of neuronal soma on the control sides was less than that on the experiment sides ( P <0.05). Conclusions The study indicated that morbidity of facial paralysis descend because capillary net on the facial nerve were avoided of damaging when excising parotid glands and anatomying facil never by surgical microscope.