摘要
作者应用Thompson技术,即不吻合神经血管的掌长肌游离移植口轮匝肌成形术治疗1例面瘫取得成功,使患侧唇部重新获得随意运动的肌功能。手术分二期,先行掌长肌去神经术,2～3周后再行掌长肌游离移植口轮匝肌成形术。文中讨论了本技术的理论根据及手术的注意事项。
Several techniques for transposition of the masseter or temporal muscles have been used and some restoration of movment has been reported. With few exception, however, it is difficult to obtain acce p-table results with these operations, because the transposed muscle has an unfavourable direction of the line of pull and this disadvantage is combined with a limited scope of contraction. An excellent procedure-transplantation of free autogenous muscle in the treatment of facial paralysis was described by Thompson in 1971. This is a great breakthrough in reconstruction surgery. This operation was performed in two steps: 1. Palmalis longus muscle was denervated 2—3 weeks prior to transplatation. The authors claimod that the favorable outcome following denervation is the result of a change in the enzyme constitution of the muscle fibre to a more economic level of metablism, which made it possible for the transplant to survive the period of avascularity before the reestablishment of effective circulation. 2. Reconstraction of orbicularis oris: The intention of the operation is to encircle the mouth with a denervated muscle graft, thereby obtaining reinnervation from the normal half of the orbicularis oris muscle. The muscle transplant was split longitudinally, paralleling with the lay of its fibres, as far as the tendinous attachment. The tendon of transplant was passed subcutaneously to the zygomatic arch and fixed around this bone in order to give static support, keeping the mouth in a balanced position when the face was at rest. We used this procedure for treating a female patient of 45 years in age with total right-side facial palsy caused by operation for a acoustic nerve tumor two years ago. Postoperatively the patient was observed for 4 more months. She showed improvement of spincteric action on pursing the lips and whistle, which was previously imposible. EMG examination showed reinnervalion of free muscle graft.
出处
《军医进修学院学报》
CAS
1992年第1期8-11,共4页
Academic Journal of Pla Postgraduate Medical School
关键词
掌长肌
移植自体
面神经麻痹
外科手术
Palmalis longis muscle Transplantation,autologous Facial paralysis Surgery
