面部神经肌肉系统功能障碍的一种评价手段——面部残疾指数及其信度和效度

面部运动功能的损害与脑干的面神经核、面神经及其分支、面肌等病变有关,并会产生饮食、言语和情绪表达等方面的功能障碍。所产生明显的容貌异样或不自主表情,可引发一些社会心理方面的问题,包括社会活动中的人际关系和工作关系以及情绪活动转变、自尊程度下降、焦虑、抑郁和行为改变等问题。目前,与面神经疾病有关的躯体功能,如ADL和面部表情表达,以及与该疾病有关的社会心理因素,尚无系统的评价方法。

CHARACTERISTIC OF FACIAL MUSCLE AND EFFERENT NERVE ON PHYSIOLOGY AND ANATOMY

Objective.To study the speciality of orbicularis oculi muscles, nerves and oris muscles, nerves and mechanism of difference of faclal muscular injury in facial paralysis deeply.Methods. The conductive velocity of the efferent nerves of orbicularis oculi and oris muscles of the health human beings and guinea pigs is measured with electromyogram (EMG) apparatus.Results. The conductive velocity of orbicularis oculi nerve is quicker and oris muscles are controlled by facial nerves on both sides. Measuring the threshold of Strength-Duration (S-D) curves of the motor point of orbicularis oculi and oris muscles shows the threshold of the former is lower. Measuring the diameter of orbicularis oculi and oris nerve fibers on the guinea pigs and rabbits shows the diameter of orbicularis oculi nerve fiber is bigger. The area of secondary synapse space of orbicularis oculi motor end plate is larger than that of oris under scanning electromicroscope.Conclusions. Orbicularis oculi muscles,orbicularis oculi nerves and oris muscles,oris nerves all have their own characteristic on physiology and anatomy. It elucidated the mechanism that orbicularis oculi muscle is easy to be injuried.

表情肌肌纤维组织化学分型及分类研究

目的 对活体表情肌组织化学特点进行研究 ,为面部表情肌动态复活提供实验依据。方法 标本均取自头面颈部手术病人切口下方的表情肌 ,并在恒冷切片机中切片后进行组织化学染色 ,包括肌动球蛋白ATP酶 (M ATPase)及还原型辅酶Ⅰ 四唑氮蓝 (NADA TR) ,结果依靠计算机辅助图像分析。结果 各表情肌肌纤维直径在 2 4 3～ 6 3 9μm之间不等 ,表情肌中同一型肌纤维直径不相同 ,P <0 0 5 ,各表情肌中各型肌纤维数量分布不同。Ⅰ型肌纤维占 2 0 %以下为位移型肌肉 ;Ⅰ型肌纤维占 2 1%～ 40 %为中间型肌肉 ;Ⅰ型肌纤维占 40 %以上为张力型肌肉。结论 表情肌组织学及组织化学上的差别在面部神经肌肉修复中有一定的意义。