吻合神经血管的股直肌肌瓣游离移植治疗晚期面瘫的改进

目的：探索吻合神经血管的动力性功能肌肉游离移植治疗晚期面瘫的方法。方法：自1994年以来我们在股直肌肌肉内神经血管解剖研究的基础上，采用带神经和肌肉内肌腱的股直肌肌瓣的吻合神经血管的游离移植治疗晚期面瘫7例。结果：术后患者于静态时双侧口角对称。2例在术后8个月恢复口角自主活动，另5例均在术后10－12个月恢复口角自主活动。结论：带肌肉肌肌腱的股直肌肌瓣的吻合神经血管的游离移植，既有利于劈裂肌肉瓣时避免血管神经损伤，又有利于维持移植肌瓣的正常肌张力以及悬吊下垂的口角。

Transferring neurovascular rectus femoris muscle segment for treatment of facial paralysis

Objective To investigate a new technique for functional treatment of chronic facial paralysis. Methods Based on anatomy of intramuscular neurovascular structure in the rectus femoris muscle, 7 consecutive patients with facial paralysis were treated by using a technique of microsurgically free-transferring neurovascular rectus femoris muscle segment to the face in one-stage. Follow-ups were 10 to 24 months. Results All of the 7 patients showed significantly improvement in the appearance of the oral commissure and oral competence. No complications occurred in the donor site. Conclusions The above mentioned technique may have the advantages of preventing the intramuscular nerve and vessel from the surgical injury during splitting the muscle. It could also maintain the transferred muscular segment in a proper tension in the recipient site. ;