受区带蒂筋膜包绕耳大神经移植治疗面神经缺失性损伤

Treating defective damage of facial nerve with great auricular nerve grafting covered by pediculated fascial tube

目的 评价带蒂筋膜包绕耳大神经移植治疗面神经缺失性损伤的临床疗效。方法耳源性与外伤性面神经缺失损伤 7例 ,取带蒂的颞肌筋膜或腮腺咬肌筋膜 ,在移植的耳大神经下方包绕移植神经和两端吻合口形成管筒 ,将移植神经首尾颠倒行束膜缝合。结果 4例耳源性面瘫 ,神经移植术后随访 2 0～ 2 5年 ,面神经功能由Ⅳ级 3例 ,Ⅴ级 1例 ,恢复至Ⅲ级 3例 ,Ⅵ级 1例 ;3例外伤性面瘫神经移植术后随访 2年 ,面神经功能由Ⅵ级恢复均达Ⅲ级。结论 受区带蒂筋膜包绕耳大神经移植 ,提供血运良好的神经修复与再生的生物学环境 。

Objective To study the curative effect of grafting great auricular nerve with pediculated fascial tube in defective damage of facial nerve Methods All the 7 patients in this study were treated by grafting great auricular nerve covered by pediculated fascial tube near facial nerve trunk Results Four cases with otogenic facial paralysis had grade Ⅲ~Ⅳ recovery of facial nerve function from two to two and half years after the nerve grafting operation Three patients post traumatic facial paralysis had grade Ⅲ recovery of facial nerve fumction 2 years after the nerve grafting operation Conclusions The grafting of pediculated fascial tube surrounded great auricular nerve can provide a biological environment with better blood supply for the plerosis and regeneration of nerve and can accelerate the functional recovery of nerves after the nerve grafting