Objective: To investigate the outcomes of masseter nerve-innervated free gracilis muscle transfer for smile reanimation in adults and to explore surgical indications. Methods: A retrospective chart review of 37 patients (11 males, 26 females, with (40.3±12.7) years old)who underwent masseter nerve-innervated free gracilis muscle transfer for smile reanimation between 2016 and 2017 was performed. Patient-reported quality of life (facial clinimetric evaluation, FaCE), physician-reported facial function (eFACE facial grading scale), and oral commissure excursion were compared preoperatively and postoperatively. SPSS 11.0 software was used to analyze the data. Results: Thirty-seven patients were followed up in one year after surgery. Significant postoperative improvements were demonstrated for commissure excursion with smile (preoperatively: (-1.2±3.1) mm, postoperatively: (6.1±3.5) mm, t=-31.1, P<0.01), ipsilateral FaCE (preoperatively: (29.4±14.1), postoperatively: (57.6±23.4), t=-38.1, P<0.01), eFACE score (Composite score t=-35.8, Static score t=-29.1, Dynamic score t=-41.3,Midface score t=-43.9, all P<0.01), respectively. Conclusion: Masseter nerve-innervated free gracilis muscle transfer is an good option for dynamic smile reanimation in adult patients who have undergone treatment for long-standing facial paralysis.
目的： 评价咬肌神经支配股薄肌移植术治疗成人晚期面神经麻痹的疗效。 方法： 回顾性分析中日友好医院2016—2017年37例接受股薄肌移植术的晚期面神经麻痹患者的资料。其中男11例，女26例；年龄（40.3±12.7）岁。对股薄肌移植术前、术后口角移动距离（ΔT-C）、患者自评面肌功能量表（facial clinimetric evaluation，FaCE）评分，医生使用电子化临床面神经麻痹评估量表（electronic，clinician-graded facial function scale，eFACE）评分的差异。使用SPSS 11.0软件对符合正态分布的数据进行配对t检验。 结果： 术后随访1年，手术前后患侧口角移动距离［ΔT-C术前为（-1.2±3.1）mm，ΔT-C术后为（6.1±3.5）mm］差异有统计学意义（t=-31.1，P<0.01）；手术前后FaCE分别为（29.4±14.1）分、（57.6±23.4）分，差异有统计学意义（t=-38.1，P<0.01）；手术前后微笑总分、静态评分、动态评分、中面部评分4种状态下eFACE 评分差异均有统计学意义（t值分别为-35.8、-29.1、-41.3、-43.9，P值均<0.01）。 结论： 咬肌神经支配股薄肌移植是成人晚期面神经麻痹治疗的有效手段。.