One‐Stage Transfer of the Latissimus Dorsi Muscle for Reanimation of a Paralyzed Face: A New Alternative
One‐Stage Transfer of the Latissimus Dorsi Muscle for Reanimation of a Paralyzed Face: A New Alternative
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背阔肌一期移植使瘫痪面部复活：一种新的选择
DOI：
10.1097/00006534-199809020-00001
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发表时间：
1998
影响因子：
3.6
通讯作者：
K. Ueda
中科院分区：
文献类型：
--
作者：
K. Harii;H. Asato;K. Yoshimura;Y. Sugawara;T. Nakatsuka;K. Ueda
&NA;结合神经血管游离肌转移和跨面神经移植的两阶段方法现在是一种广泛接受的手术，用于长期单侧面瘫患者的动态微笑重建。虽然结果是有希望的，但这两次手术间隔约1年，给病人带来经济负担，需要很长时间才能取得结果。在移植腓肠神经时，如感觉减退、感觉异常、供者腿上明显的疤痕等后遗症也不能忽视。为了克服两阶段方法的这些缺点，我们报告了一种改进的技术，利用一期微血管游离转移背阔肌。将其胸背神经穿过上唇与对侧完整的面神经分支缝合。移植肌肉的神经再支配平均在术后7个月建立，这比两阶段方法更快。在我们目前的24例患者中，21例患者（超过87%）认为他们的结果非常好或令人满意，这也与结合游离肌肉移植和跨面神经移植的两阶段方法的结果相比较。（Plast。重建102：941，1998）。
&NA; The two‐stage method combining neurovascular freemuscle transfer with cross‐face nerve grafting is now a widely accepted procedure for dynamic smile reconstruction in cases with long established unilateral facial paralysis. Although the results are promising, the two operations, about 1 year apart, exert an economic burden on the patients and require a lengthy period before obtaining results. Sequelae such as hypoesthesia, paresthesia, and conspicuous scar on the donor leg for harvesting a sural nerve graft also cannot be disregarded. To overcome such drawbacks of the two‐stage method, we report a refined technique utilizing one‐stage microvascular free transfer of the latissimus dorsi muscle. Its thoracodorsal nerve is crossed through the upper lip and sutured to the contralateral intact facial nerve branches. Reinnervation of the transferred muscle is established at a mean of 7 months postoperatively, which is faster than that of the two‐stage method. In our present series with 24 patients, 21 patients (more than 87 percent) believed that their results were excellent or satisfactory, which also compares well with the results of the two‐stage method combining free‐muscle transfer with cross‐face nerve graft. (Plast. Reconstr. Surg. 102: 941, 1998.)