PDF(Pubmed)
Abstract：
Introduction Facial trauma can cause damage to the facial nerve, which can have negative effects on function, aesthetics, and quality of life if left untreated. Objective To evaluate the effectiveness of peripheral facial nerve direct end-to-end anastomosis and/or nerve grafting surgery for patients with facial nerve injury after facial trauma. Methods Fifty-nine patients with peripheral facial nerve paralysis after facial injuries underwent facial nerve rehabilitation surgery from November 2017 to December 2021 at Ho Chi Minh City National Hospital of Odontology. Results All 59 cases of facial trauma with damage to the peripheral facial nerve underwent facial nerve reconstruction surgery within 8 weeks of the injury. Of these cases, 25/59 (42.3%) had end-to-end anastomosis, 22/59 (37.3%) had nerve grafting, and 12/59 (20.4%) had a combination of nerve grafting and end-to-end anastomosis. After surgery, the rates of moderate and good recovery were 78.4% and 11.8%, respectively. All facial paralysis measurements showed statistically significant improvement after surgery, including the Facial Nerve Grading Scale 2.0 (FNGS 2.0) score, the Facial Clinimetric Evaluation (FaCE) scale, and electroneurography. The rate of synkinesis after surgery was 34%. Patient follow-up postoperatively ranged from 6 to > 36 months; 51 out of 59 patients (86.4%) were followed-up for at least 12 months or longer. Conclusion Nerve rehabilitation surgery including direct end-to-end anastomosis and nerve grafting is effective in cases of peripheral facial nerve injury following facial trauma. The surgery helps restore nerve conduction and improve facial paralysis.
摘要：
引言面部外伤会对面神经造成损伤,会对功能产生负面影响，美学，和生活质量如果不及时治疗。目的评价周围面神经直接端对端吻合术和/或神经移植术治疗面外伤后面神经损伤的疗效。方法2017年11月至2021年12月在胡志明市国立牙本质医院接受面神经康复手术治疗的59例面部损伤后周围性面神经麻痹患者。结果59例面部外伤伴周围面神经损伤患者均在损伤后8周内行面神经重建术。在这些案件中,25/59（42.3％）进行了端到端吻合，22/59（37.3%）进行了神经移植，和12/59（20.4％）的神经移植和端到端吻合的组合。手术后,中等和良好回收率分别为78.4%和11.8%，分别。所有面瘫测量结果均显示手术后有统计学上的显着改善，包括面神经分级量表2.0（FNGS2.0）评分，面部临床评估(FaCE)量表，和神经电子学。手术后的联合运动率为34％。患者术后随访6至36个月；59例患者中有51例（86.4%）随访至少12个月或更长时间。结论神经康复手术包括直接端对端吻合和神经移植对面部创伤后周围性面神经损伤的治疗是有效的。手术有助于恢复神经传导和改善面瘫。
