面神经-舌下神经显微吻合手术治疗周围性面瘫

周围性面神经瘫痪主要表现为提额、皱眉、鼓颊、露齿等动作困难以及鼻唇沟变浅、歪斜,嘴角低垂,患侧额纹不明显,闭目时可见眼球向上翻动(Bell现象),舌运动及味觉功能障碍.我院自1998年6月～2000年8月共收治周围性面瘫患者6例,均施行面神经-舌下神经显微外科吻合手术,结果报告如下.

甲磺酸罗哌卡因芬太尼用于臂丛神经阻滞的临床观察

单纯甲磺酸罗哌卡因臂丛神经阻滞经常会出现阻滞不全的情况,在骨折断端分离、牵拉、内固定时,患者常会出现局部疼痛,烦躁不安等现象;特别是肌腱、血管、神经吻合手术时,直接影响手术的顺利进行和患者生理功能的稳定。本研究旨在观察芬太尼复合甲磺酸罗哌卡因臂丛神经阻滞的效果。

CROSSING ANASTOMOSIS OF NERVE BUNDLES NEAR INNERVATED ORGANS TO TREAT IRREPARABLE NERVE INJURIES

Objective To study the therapeutical effects of crossing anastomosis of nerve on the peripheral and central nerve injuries. Methods Twelve kinds of central and peripheral nerve disorders and their complications were treated with 11 kinds of crossing anastomosis of nerve bundles near the innervated organs. After nerve injury and repair, somatosensory evoked potentials （SEPs） and horseradish peroxidase （HRP） retrograde tracing studies were used to investigate the rabbit＇s nerve function and morphology. Resets The ulcers of all patients healed. Sensation, voluntary movement, and joint function recovered. Four weeks after the anastomosis of distal stump of radialis superficialis nerve and median nerve, pain sensation regained and SEPs appeared. HRP retrograde tracing studies demonstrated sensory nerve ending of medial nerve formed new connection with the body of neuron. Conclusion Crossing anastomosis of nerve is an effective method to treat peripheral and central nerve injuries.

“拯救”永久性面瘫的好办法

在面神经瘤、听神经瘤，以及中耳胆脂瘤手术中，面神经损伤有时是无法避免的，部分患者会在术后出现不同程度的面瘫，严重者会出现眼睛无法闭合、口角歪斜等严重面部畸形。近年来，我科采用咬肌神经一面神经吻合手术，恢复瘫痪的面部肌肉，取得了不错的效果。