舌下神经-面神经侧端吻合术治疗小脑脑桥角肿瘤术后面瘫

摘要：目的探讨舌下神经-面神经侧端吻合术治疗小脑脑桥角肿瘤术后面瘫的效果。方法6例小脑脑桥角肿瘤切除术后面瘫患者均行舌下神经-面神经侧端吻合术。所有患者术后每3个月随访1次，评估House Brackmann(H B)分级和舌下神经功能。结果术后1年H B III级2例,H B Ⅳ级3例, H B V级1例。静态面部张力4例患者在吻合术后6个月改善明显，1例患者在吻合术后 9个月改善，1例患者在吻合术后1年改善。所有患者均未出现术侧舌肌瘫痪萎缩，发音和吞咽功能均正常。结论舌下神经-面神经侧端吻合术可改善小脑脑桥角肿瘤切除术后面瘫患者的面部张力和面肌功能，借助神经监护可尽量减小对舌肌功能的影响。

Side to end hypoglossal to facial nerve anastomosis for facial reanimation after cerebellopontine angle tumor resection

Abstract:ObjectiveTo investigate surgical effect of side to end hypoglossal to facial nerve anastomosis after cerebellopontine angle tumor resection.MethodsA total of 6 patients underwent tumor resection in cerebellopontine angle received side to end hypoglossal to facial nerve anastomosis. All patients were followed up every three months, and their grade of House Brackmann (H B) and tongue function were evaluated.ResultsOne year after surgery, 2 patients achieved H B grade III,3 grade IV, and one grade V. Four patients achieved good facial tone at 6 months after reconstructive surgery, and the rest achieved at 9 months and one year respectively. Significant tongue atrophy, impaired tongue mobility, speech or swallow dysfunction occurred in none.ConclusionsSide to end hypoglossal to facial nerve anastomosis is an efficient way to reanimate facial paralysis after cerebellopontine angle tumor resection. Intraoperative nerve monitor may be beneficial to the protection of tongue function.