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目的 探讨不同程度面神经失神经支配后口轮匝肌线粒体结构、琥珀酸脱氢酶 (SDH)的变化与面肌功能恢复的关系。方法 制造颞骨内面神经麻痹模型 ,分为面神经压榨 5s组、15s组、3 0s组 ,再分为观察 15d组、3 0d组。应用神经电图测试 5s组、15s组、3 0s组的平均阈值差值。SDH染色后 ,透射电镜观察各 15d组、3 0d组口轮匝肌线粒体结构和SDH阳性反应产物的变化。结果 面神经压榨 5s组的平均神经兴奋传导抑制时间为 (3 5 .2± 16.8)min ;15s组瞬目反射恢复正常需 (4 7.0± 15 .0 )d ;3 0s组半年内未恢复。 15s15d组线粒体嵴断裂 ,SDH阳性反应颗粒减少 ;3 0d组基本恢复正常。 3 0s15d组线粒体空泡变性 ,SDH颗粒明显减少 ;3 0d组的线粒体结构和SDH颗粒有轻度恢复。结论 面神经受损伤时间越长 ,失神经支配程度越重 ,线粒体病变也越重 ,面肌功能恢复越难 ,应早期行面神经减压术
Objective To investigate the relationship between mitochondrial structure and succinate dehydrogenase (SDH) in the orbicularis oris muscle and the recovery of facial muscles after different degrees of facial nerve denervation. Methods The facial palsy model of temporal bone was made and divided into 5s group, 15s group and 30s group and then divided into 15d group and 30d group. The mean threshold difference of 5s group, 15s group, and 30s group was tested by electropathological examination. After SDH staining, the changes of mitochondrial structure and SDH positive reaction products of orbicularis oris in each group were observed by transmission electron microscope at 15d and 30d respectively. Results The mean nerve conduction time of 5s group was (3.52 ± 16.8) min after facial nerve crushing, and was normal at 15s (4 7.0 ± 15.0 days). The 30s group did not recover within 6 months. 15s15d mitochondrial crista fracture, SDH-positive particles decreased; 30d group returned to normal. At 30s15d, mitochondria were denatured and SDH particles were significantly reduced; mitochondrial structure and SDH particles recovered slightly on the 30th day. Conclusions The longer the facial nerve is injured, the more denervated innervation, the heavier the mitochondrial lesions, the harder the facial muscle functions to recover. In the early stage, facial nerve decompression