Multivectored suture suspension: a minimally invasive technique for reanimation of the paralyzed face.
Multivectored suture suspension: a minimally invasive technique for reanimation of the paralyzed face.
复制标题
多向量缝合悬吊：一种使瘫痪面部复活的微创技术。
DOI：
10.1001/archfaci.6.3.197
复制
发表时间：
2004
影响因子：
--
通讯作者：
D. B. Nguyen
中科院分区：
文献类型：
--
作者：
James C. Alex;D. B. Nguyen
背景
尽管有先进的面部下半部复苏技术，但许多患者选择静态悬吊手术，这种手术创伤较小，恢复期相对较短。然而，即使是静态悬吊手术也需要全身麻醉、住院过夜和重要的软组织操作。我们提出了一种微创技术，多向量缝线悬吊，解决了这些缺点。
目标
目的：探讨多向量缝线悬吊术在瘫痪面神经手术中的技术可行性和疗效。
设计
这项研究是在12例House-Brackmann 6级面瘫患者中进行的。9例患者在肿瘤切除术后6个月内就诊，3例患者在手术后1年以上就诊。
主要观察指标
评价的参数为（1）。恢复鼻呼吸;（2）.改善流口水;（3）.恢复正常言语;（4）。美容效果;和（5）.总手术时间。
结果
平均随访14个月，患者对结局参数的评价如下：（1）。10例患者（83%）报告鼻呼吸显著恢复，2例（17%）报告中度恢复;（2）。10例患者（83%）报告显著改善，2例（17%）报告中度流涎改善;（3）。8例患者（66%）报告显著改善，4例（34%）报告中度改善;（4）。9名患者（75%）报告对美容完全满意，3名患者（25%）报告对美容中度满意。平均手术时间为46分钟。由于缝线失效，需要进行3次翻修。
结论
多向量缝合悬吊技术是一种微创、可逆的下面部复苏方法，可改善美容效果，恢复鼻呼吸。它可以在门诊局部麻醉下进行，从而降低发病率和成本。
BACKGROUND
Despite advanced techniques for reanimation of the lower face, many patients opt for static suspension procedures, which are less invasive and have a relatively short recovery period. However, even static suspension procedures require general anesthesia, overnight hospital stay, and significant soft tissue manipulation. We present a minimally invasive technique, the multivectored suture suspension, which addresses these drawbacks.
OBJECTIVES
To study the technical feasibility and efficacy of the multivectored suture suspension technique in the paralyzed face.
DESIGN
The study was carried out prospectively in 12 patients with House-Brackmann grade 6 facial paralysis. Nine patients presented within 6 months of tumor resection and 3 patients presented more than 1 year after surgery.
MAIN OUTCOME MEASURES
The parameters evaluated were (1). restoration of nasal breathing; (2). improvement of drooling; (3). restoration of normal speech; (4). cosmetic results; and (5). total surgical time.
RESULTS
With an average follow-up of 14 months, patient evaluation of the outcome parameters was as follows: (1). 10 patients (83%) reported significant and 2 (17%) reported moderate restoration of nasal breathing; (2). 10 patients (83%) reported significant improvement and 2 (17%) reported modest drooling improvement; (3). 8 patients (66%) reported significant improvement and 4 (34%) reported modest improvement of speech; (4). 9 patients (75%) reported complete satisfaction and 3 (25%) reported moderate satisfaction with cosmesis. The average surgical time was 46 minutes. Three revisions were required for suture failure.
CONCLUSIONS
The multivectored suture suspension technique is a minimally invasive, reversible method of lower facial reanimation that provides improved cosmesis with restoration of nasal breathing. It can be performed under local anesthesia in an outpatient setting, thereby reducing morbidity and cost.