受区带蒂筋膜包绕耳大神经移植治疗面神经缺失性损伤

目的 评价带蒂筋膜包绕耳大神经移植治疗面神经缺失性损伤的临床疗效。方法 耳源性与外伤性面神经缺失损伤7例，取带蒂的颞肌筋膜或腮腺咬肌筋膜，在移植的耳大神经下方包绕移植神经和两端吻合口形成管筒，将移植神经首尾颠倒行束膜缝合。结果 4例耳源性面瘫，神经移植术后随访2．0～2．5年，面神经功能由Ⅳ级3例，Ⅴ级1例，恢复至Ⅲ级3例，Ⅵ级1例；3例外伤性面瘫神经移植术后随访2年，面神经功能由Ⅵ级恢复均达Ⅲ级。结论 受区带蒂筋膜包绕耳大神经移植，提供血运良好的神经修复与再生的生物学环境，促进术后面神经功能的恢复。

Treating defective damage of facial nerve with great auricular nerve grafting covered by pediculated fascial tube]

OBJECTIVE: To study the curative effect of grafting great auricular nerve with pediculated fascial tube in defective damage of facial nerve. METHODS: All the 7 patients in this study were treated by grafting great auricular nerve covered by pediculated fascial tube near facial nerve trunk. RESULTS: Four cases with otogenic facial paralysis had grade III - IV recovery of facial nerve function from two to two and half years after the nerve grafting operation. Three patients post-traumatic facial paralysis had grade III recovery of facial nerve function 2 years after the nerve grafting operation. CONCLUSIONS: The grafting of pediculated fascial tube surrounded great auricular nerve can provide a biological environment with better blood supply for the plerosis and regeneration of nerve and can accelerate the functional recovery of nerves after the nerve grafting.