■确定弛缓性面瘫患者面神经重建手术后的功能结局。
■对报告面神经直接缝合(DFS)后结局的研究进行了系统评价和荟萃分析,面神经插入移植缝线(图),舌下神经-面神经缝合术(HFS),咬面神经缝合(MFS),和交叉面神经缝合(CFS)。这些研究来自PubMed/MEDLINE,Embase,和WebofScience数据库。两名独立的审阅者进行了两个阶段的筛选和数据提取。有利的结果被定义为最终的House-Brackmann等级I-III,并以所有患者的百分比表示。使用随机效应模型计算集合比例。
■从4,932条筛选记录中,纳入54项研究,1,358例患者。42.67%的患者在DFS后获得了良好的结果[置信区间(CI):26.05%-61.12%],在66.43%(CI:55.99%-75.47%)之后,HFS后63.89%(95%CI:54.83%-72.05%),在63.11%的MFS后(CI:38.53%-82.37%),CFS后为46.67%(CI:24.09%-70.70%)。技术之间没有统计学上的显着差异(Q=6.56,自由度=4,p=0.1611)。
■已建立的面神经重建技术,包括单神经交叉转移技术,在大多数永久性弛缓性面瘫患者中产生了令人满意的效果。关于标准化结果措施的国际共识将提高面部复活技术的可比性。
UNASSIGNED: To determine the functional outcome after facial nerve reconstruction surgery in patients with flaccid facial paralysis.
UNASSIGNED: A systematic review and meta-analysis was performed on studies reporting outcomes after direct facial nerve suture (DFS), facial nerve interpositional graft suture (FIGS), hypoglossal-facial nerve suture (HFS), masseteric-facial nerve suture (MFS), and cross-face nerve suture (CFS). These studies were identified from PubMed/MEDLINE, Embase, and Web of Science databases. Two independent reviewers performed two-stage screening and data extraction. A favorable result was defined as a final House-Brackmann grade I-III and is presented as a ratio of all patients in percentage. Pooled proportions were calculated using random-effects models.
UNASSIGNED: From 4,932 screened records, 54 studies with 1,358 patients were included. A favorable result was achieved after DFS in 42.67% of the patients [confidence interval (CI): 26.05%-61.12%], after FIGS in 66.43% (CI: 55.99%-75.47%), after HFS in 63.89% (95% CI: 54.83%-72.05%), after MFS in 63.11% (CI: 38.53%-82.37%), and after CFS in 46.67% (CI: 24.09%-70.70%). There was no statistically significant difference between the techniques (Q = 6.56, degrees of freedom = 4, p = 0.1611).
UNASSIGNED: The established facial nerve reconstruction techniques including the single nerve cross-transfer techniques produce satisfactory results in most of the patients with permanent flaccid facial paralysis. An international consensus on standardized outcome measures would improve the comparability of facial reanimation techniques.