Abstract：
The purpose of this study was to evaluate the outcomes of our polyneural, zone-based reanimation approach for patients with neoplasm-induced facial paralysis.
A retrospective review of consecutive patients who underwent facial reanimation surgery using multiple donor nerve transfers was undertaken. In each case, the selection of donor nerves was based on the availability of donor nerve and the viability of the motor endplate on the affected side. Sources of the neural inputs utilized included the remnant facial nerve stump, masseteric nerve, partial hypoglossal nerve, and branches of the contralateral facial nerve. Clinical outcomes were scored by expert raters. Ratings were undertaken using the modified House-Brackmann, eFACE and MEEI FACEgram scoring systems.
Between 2017 and 2020, 12 patients were included in the study (mean age 60 years; range 26-81 years). Eight patients (67%) achieved a grade III outcome on the modified House-Brackmann grading scale. Mean eFACE static and dynamic scores were 76 and 57 respectively, reflecting a high degree of symmetry at rest and moderate restoration of dynamic movement. Mean time to movement was 5.4 months (SD 1.9). Objective FACE-gram measurements confirmed restoration of midface movement with an average improvement in smile excursion and mouth angle excursion of 3.19 mm (SD 3.18) and 4.81° (SD 2.90) respectively.
Facial reanimation using multiple nerve transfers is effective in achieving improvements in facial function and symmetry.
A retrospective review of consecutive patients who underwent facial reanimation surgery using multiple donor nerve transfers was undertaken. In each case, the selection of donor nerves was based on the availability of donor nerve and the viability of the motor endplate on the affected side. Sources of the neural inputs utilized included the remnant facial nerve stump, masseteric nerve, partial hypoglossal nerve, and branches of the contralateral facial nerve. Clinical outcomes were scored by expert raters. Ratings were undertaken using the modified House-Brackmann, eFACE and MEEI FACEgram scoring systems.
Between 2017 and 2020, 12 patients were included in the study (mean age 60 years; range 26-81 years). Eight patients (67%) achieved a grade III outcome on the modified House-Brackmann grading scale. Mean eFACE static and dynamic scores were 76 and 57 respectively, reflecting a high degree of symmetry at rest and moderate restoration of dynamic movement. Mean time to movement was 5.4 months (SD 1.9). Objective FACE-gram measurements confirmed restoration of midface movement with an average improvement in smile excursion and mouth angle excursion of 3.19 mm (SD 3.18) and 4.81° (SD 2.90) respectively.
Facial reanimation using multiple nerve transfers is effective in achieving improvements in facial function and symmetry.
摘要：
背景：这项研究的目的是评估我们的多神经，肿瘤性面瘫患者的区域重建方法。
方法：对使用多个供体神经转移进行面部修复手术的连续患者进行回顾性分析。在每种情况下，供体神经的选择基于供体神经的可用性和患侧运动终板的活力。使用的神经输入源包括剩余的面神经残端，咬神经,部分舌下神经,和对侧面神经的分支。临床结果由专家评分员评分。评级是使用修改后的House-Brackmann进行的，eFACE和MEEIFACEgram评分系统。
结果：在2017年至2020年之间，有12名患者被纳入研究（平均年龄60岁；范围26-81岁）。8例患者（67%）在改良的House-Brackmann分级量表上达到了III级结果。平均eFACE静态和动态评分分别为76和57，反映了静止时的高度对称性和动态运动的适度恢复。平均运动时间为5.4个月（SD1.9）。目标FACE-gram测量证实了面部中部运动的恢复，微笑偏移和嘴角偏移的平均改善分别为3.19mm（SD3.18）和4.81°（SD2.90）。
结论：使用多个神经转移的面部修复可有效改善面部功能和对称性。
方法：对使用多个供体神经转移进行面部修复手术的连续患者进行回顾性分析。在每种情况下，供体神经的选择基于供体神经的可用性和患侧运动终板的活力。使用的神经输入源包括剩余的面神经残端，咬神经,部分舌下神经,和对侧面神经的分支。临床结果由专家评分员评分。评级是使用修改后的House-Brackmann进行的，eFACE和MEEIFACEgram评分系统。
结果：在2017年至2020年之间，有12名患者被纳入研究（平均年龄60岁；范围26-81岁）。8例患者（67%）在改良的House-Brackmann分级量表上达到了III级结果。平均eFACE静态和动态评分分别为76和57，反映了静止时的高度对称性和动态运动的适度恢复。平均运动时间为5.4个月（SD1.9）。目标FACE-gram测量证实了面部中部运动的恢复，微笑偏移和嘴角偏移的平均改善分别为3.19mm（SD3.18）和4.81°（SD2.90）。
结论：使用多个神经转移的面部修复可有效改善面部功能和对称性。
