本文選題：耳大神經(jīng) + 移植��； 參考：《臨床耳鼻咽喉頭頸外科雜志》2017年16期

【摘要】：目的:探討采用電纜狀耳大神經(jīng)即刻移植修復(fù)腮腺癌切除術(shù)后面神經(jīng)缺損的可行性。方法:因腮腺癌切除面神經(jīng)后采用電纜狀耳大神經(jīng)移植即刻重建面神經(jīng)患者11例,其中黏液表皮樣癌9例,腺樣囊性癌2例,均行患側(cè)腮腺全切+腫瘤累及段面神經(jīng)干及分支切除+同期電纜狀耳大神經(jīng)修復(fù)重建+擇區(qū)性頸淋巴結(jié)清掃術(shù)。面神經(jīng)缺損分為面神經(jīng)干及分支、顳面干及分支和頸面干及分支3個(gè)類型;術(shù)后記錄患者面部肌肉運(yùn)動狀態(tài)對稱性及行雙側(cè)面神經(jīng)肌電圖檢測;House-Brackmann(H-B)面神經(jīng)功能分級系統(tǒng)評價(jià)面神經(jīng)功能恢復(fù)情況。8例患者術(shù)后接受50~65Gy放療。術(shù)后隨訪8~36個(gè)月,平均12個(gè)月。結(jié)果:在擬修復(fù)的面神經(jīng)功能區(qū),7例患者獲得滿意的閉眼功能(7/7);5例患者可見明顯的皺額(5/7);9例患者靜態(tài)時(shí)可獲得對稱的口角和鼻唇溝(9/9);4例患者放療后3個(gè)月,面神經(jīng)功能仍有明顯改善。9例患者獲得H-B分級Ⅱ級、2例獲得Ⅲ級的康復(fù)效果。H-B分級為Ⅱ級的9例患者患側(cè)面神經(jīng)肌電活動仍較健側(cè)輕微減弱。結(jié)論:電纜狀耳大神經(jīng)移植能有效修復(fù)腮腺癌切除術(shù)后面神經(jīng)缺損,可作為即刻面神經(jīng)缺損重建的方法。腮腺區(qū)的游離神經(jīng)移植可能不是術(shù)后放療的禁忌證。
[Abstract]:Objective: to investigate the feasibility of repairing facial nerve defect after parotid carcinoma resection with cable auricular nerve. Methods: eleven cases of facial nerve were reconstructed with cable auricular nerve transplantation, including 9 cases of mucoepidermoid carcinoma and 2 cases of adenoid cystic carcinoma. All the patients underwent total resection of the parotid gland involving the segmental facial nerve trunk and branch excision and selective cervical lymph node dissection for the repair and reconstruction of the great auricular nerve. The defects of facial nerve were divided into three types: trunk and branch of facial nerve, temporal trunk and branch, cervical trunk and branch. After operation, the symmetry of facial muscle movement status was recorded and bilateral facial nerve electromyography was performed to evaluate the recovery of facial nerve function by House-Brackmannn H-B. eight patients were treated with 50,65Gy radiotherapy after operation. Postoperative follow-up ranged from 8 to 36 months (mean 12 months). Results: in 7 patients with facial nerve functional area to be repaired, 7 / 7 patients had satisfactory eye closure function. In 5 patients, 5 / 7 patients could get symmetrical angle of mouth and 9 / 9 of nasolabial sulcus in static state. 3 months after radiotherapy, 4 patients with 9 / 9 of nasolabial sulcus were treated with radiotherapy, and 3 months after radiotherapy, 5 / 7 / 7 / 7 of the patients could obtain symmetrical angle of mouth and 9 / 9 / 9 of nasolabial sulcus after radiotherapy. The facial nerve function was still significantly improved in 9 patients with H-B grade 鈪，

本文編號：2018733