Symmetry Restoration at Rest after Masseter-to-Facial Nerve Transfer: Is It as Efficient as Smile Reanimation?
Symmetry Restoration at Rest after Masseter-to-Facial Nerve Transfer: Is It as Efficient as Smile Reanimation?
复制标题
咬肌至面神经移植后静息时的对称性恢复：是否与微笑复活一样有效？
DOI：
10.1097/prs.0000000000003698
复制
发表时间：
2017-10-01
影响因子：
3.6
通讯作者：
Yang, Xianxian
中科院分区：
文献类型：
--
作者：
Chen, Gang;Wang, Wenjin;Yang, Xianxian
背景资料：咬肌-面神经移位术是一种高效的麻痹肌肉复苏技术，据报道可以恢复面部的对称性。然而，没有进行系统的研究，术前下垂的口腔联合术后对称性在休息的影响很少report.Methods：作者回顾性分析了35例咬肌-面神经吻合术，并评估了质量和数量的动态恢复和口腔联合对称性在休息。结果：所有患者术后Terzis评分均较术前提高，半数以上患者恢复对称性微笑（Terzis评分4 ~ 5分）。35名患者中有18名患者的术后口腔联合的对称性评分在静息状态下得到改善。术后口连合偏移的平均高度差和双侧口连合位置的高度差均较术前减小。术前对称性对术后双侧口连合位置的高度差有显著影响。动态和静态对称性改进的影响被转换为可比较的因子a。结论：咬肌-面神经移位术是一种可靠的微笑重建技术。然而，它对静止对称性的改善作用有限。术前评估静息时口腔联合的对称性可用于预测术后结果，口腔联合严重下垂（对称性量表III或IV级）的患者应接受静态悬吊。
Background: Masseter-to-facial nerve transfer is a highly efficient technique for reanimating paralyzed muscle and has been reported to restore facial symmetry at rest. However, no systematic studies have been performed, and the effects of preoperative droop of the oral commissure on postoperative symmetry at rest have rarely been reported.Methods: The authors retrospectively analyzed 35 patients with masseteric-to-facial nerve anastomosis and assessed the quality and quantity of the dynamic recovery and the oral commissure symmetry at rest. The dynamic and static effects were then compared.Results: All of the patients' Terzis scores were increased postoperatively, and over half of the patients presented restored symmetric smiles (Terzis scores of 4 or 5). The postoperative symmetry scale of the oral commissure at rest improved in 18 of 35 patients. Both the mean postoperative altitude difference of oral commissure excursion and the postoperative altitude difference of bilateral oral commissure position were decreased compared with preoperative values. The preoperative symmetry had a significant effect on the postoperative altitude difference of the bilateral oral commissure position. The effects of the dynamic and static symmetry improvements were transformed to a comparable factor a. The dynamic a was significantly greater than the static a.Conclusions: Masseter-to-facial nerve transfer is a reliable technique for smile reanimation. However, it has only a limited effect on the improvement of symmetry at rest. Assessing the preoperative symmetry of the oral commissure at rest can be used to predict postoperative outcomes, and patients with severe droop of the oral commissure (symmetry scale grade III or IV) should receive static suspension.