Denervated Muscle Free Transplantation-based Method For The Treatment Of Advanced Facial Paralysis In Basic Research And Clinical Applications

Free muscle graft to reconstruct facial paralysis has been widely used in clinic in recent 10 years. Although the result is obvious,not a single method can restore all the deformity. The history review, anatomy and animal experiment about facial paralysis have been discussed in this article,so do the operation study.The anatomy is managed in the nerve and blood vessel distribution of temporalis and masseter to select proper temporal flap for transferring and masseter tunnel position,which help to reconstruct the deformity of eyes and oral commissure. The anatomy of extensor digitorum brevis (EDB)and extensor hallucis brevis(EHB)is also dicussed. The result shows:Deep temporal nerve and blood vessel is fan-shaped above the zygomatic arch,distributing at an angle of 60 degrees which divide the temporalis into 3 parts. There is reliable blood and nerve supply in the transferred anterior half muscle flap assuring its funtion after being transferred. The masseter receive blood and nerve supply at its opposing angle line,guiding the operater to make tunnel at the line anteriorly or posteriorly,and make the graft connected with mas-secter tightly in order to benifit the trigeminal nerve to penetrate the graft. There are 3 types nerve distribution of EDB and EHB. There is also variation of muscle tendon. It is sometimes comebined with the longus tendon. The observation will be benifit to the muscle being denerved and free transplanted.The animal experiment is done to verify the free muscle surviving and nerve regeneration after being transplanted. A monkey is taken to receive free transplantation of EDB and EHB after being denerved. We make the muscle biopsy to do histollogical,hischemical and electromicroscopical exam-...