Applied Basic Study Of Dynamic Correction To Later Facial Paralysis With Temporal Muscle And Galea Aponeurosis Complex Tissue Flap

Objective Through the creation of animal's model, and the massseteric muscle was observed muscle wet weight, myoelectric activity, histopathologyical observation. To investigate the changes in the physiological and structural properties of the masseter muscle after reinnervation of different reinnervated methods, and prove the feasibility that the muscle functional restoration after motor nerve implantation. At the first stage of operation, Comparison the result between grafted nerve implantation and grafted nerve anastomosis. If prove the histochemistry-type of masseter muscle fiber can be changed, it structure is similar to the expression muscle. Offer more effective method for clinical.Method There were 24 adult rabbits and divide into A and B groups randomly. Each animal has auto-control ,it cheeks is experimental side.Group A had facial nerves transplantanastomosis with masseteric nerves, group B had transplanted facial nerves implantation in the massseteric muscle. At 1, 3 and 6 months after the operation, the massseteric muscle was observed muscle wet weight, myoelectric activity, histopathologyical and ultrastructure observation.Results After the reinneration of masseter muscle, animal's face skin has not swelling, inflammation. Postoperative in the early days, the muscular flap has transparent amyotrophy. Then the amyotrophy relieve gradually. The nerve stoma growth well, it's surface has rich capillary network. In the early days postoperative muscle and nerve has not contractile response by electric stimulation, and only have denervation potential, then incubation period shortening, can measured contractile response, MCV has significantly different in both methods. II -type muscle fiber decreased gradually in the part area of masseter muscle follow time elongation, I -type muscle fiber increased gradually, Postoperative6 months, the fiber in the part area of masseter muscle is mainly I -type muscle fiber , it is similar to normal expression muscle fiber. But part fiber is more thick than normal masseter muscle fiber. In the early days postoperative the ultrastructure of the muscle fiber is unintegrity, then the structure is integrity gradually. The transplanted nerve has integrity structure, and have schwann cell encapsulated, more myelinated nerve fiber and a small quantity unmyelinated nerve fiber. The distribution of the MEP in A group is similar to control groups. The zone of MEP is on the starting point of the muscle, but the distribution of the MEP in B groups is confusion. In addition, single muscle fiber included single MEP usually, and connected with single nerve fibre bundle in the A groups and control groups . But in the B groups, single muscle fiber included multi MEP usually, and connected with multi nerve fibre bundle.Conclusions The reinnervation of masseter muscle by facial nerve was confirmed. It is similar that both reinnervated methods.The histochemistry-type of muscle fiber was changed. And it is fiber-constitution was transformed to facial muscle. The MCV of both reinnervated methods was a significant difference at 3 months post-operation(P<0.01); It was not a significant difference at 6 months post-operation(P>0.05).Offer more effective method for clinical.