晚期面神经麻痹修复过程中表情肌与颞肌电生理力学指标的对比研究

背景应用颞肌帽状腱膜复合组织瓣修复晚期面神经麻痹(以下简称面瘫),存在肌力过强的缺点,将颞肌和表情肌的电生理力学指标比较研究,希望可以避免出现术后不对称表情的情况.目的采用肌电图测定颞肌与表情肌的干扰型,为晚期面瘫施行颞肌筋膜瓣转移筛选功能指标.设计开放性试验.单位南方医科大学南方医院整形外科及临床解剖研究所.对象于2000年军校学员中选拔的健康青年志愿者18例完成本试验.方法依照肌电图原理,对表情肌及颞肌肌束的肌电图干扰型测定.主要观察指标记录并比较相应肌肉束干扰型的转折数、平均振幅和两者比值.结果颞肌可以利用的三束肌束的肌力是相应表情肌肌束的1.5倍至4倍,差异均有显著性意义.结论颞肌可分三束替代表情肌修复晚期面瘫,肌力相对较强.

Comparative study on electrophysiological mechanic indexes of mimetic muscle and temporalis in reparative process of facial paralysis at advanced stage

BACKGROUND: The shortcoming of excessive strong muscular strength may be produced when the complex tissue valve of temporalis epicranial aponeurosis is used to repair facial paralysis at advanced stage. We made a comparative study on electrophysiological mechanic indexes of mimetic muscle and temporalis in the hope that expressional asymmetry after operation can be avoided.OBJECTIVE: To determine the interference pattern(IP) of temporalis and mimetic muscle by electromyography(EMG) and screen functional index for transferring temporal musculofascial flap in advanced facial paralysis.DESIGN: An open trial.SETTING: Department of Cineplastic Surgery and Anatomy Teaching & Research Section, Nanfang Hospital affiliated to Southern Medical University.PARTICIPANTS: Eighteen healthy young volunteers from year 2000 students of the Military Academy were chosen in this experiment.METHODS: Based on the principle of EMG, IPs of muscle bundle of temporalis and mimetic muscle were determined.MAIN OUTCOME MEASURES: Turns and amplitude of corresponding muscle bundle and their ratio(T/A) were recorded and compared.RESULTS: Muscular strength of the three muscle bundles that could be utilized by temporalis was 1.5 to 4 times as that of corresponding mimetic muscle bundle. The difference was significant.CONCLUSION: Temporalis can be divided into three bundles to substitute mimetic muscle in the repair of facial paralysis at advanced stage, and muscular strength is relatively stronger.