An Abnormal Finding of Facial Nerve Trunk during Operation-A Case Report of Madelung Syndrome

不正常的顏面神經外觀與手術發現－Madelung徵候群的個案報告

林士隆(Shih-Lung Lin) ； 張立人(Li-Ren Cheng) ； 馮冠明(Guan-Ming Feng) ； 劉奕添(Yi-Tien Liu) ； 陳宏基(Hung-Chi Chen)

《臺灣整形外科醫學會雜誌》 20卷1期 (2011/03) Pp. 73-78

https://doi.org/10.7096/TJTSPS.201103.0073

摘要

背景：
Madelung症候群是一種上半身對稱性不正常脂肪組織增生。當增生的部份過多時常會造成呼吸道的不順暢及外觀上的缺陷，因此切除和腫瘤減量常常是必要的。然而，切除臉頰的腫瘤常常需要分離顏面神經的分支。在病態性的狀況下顏面神經的大小可能會嚴重的改變。
目的和目標：
藉由我們所提出的病例報告提供本院治療Madelung症候群的方法與顏面神經臨床的發現。
材料及方法：
這裡我們舉出一個34歲的男性，他在頸部、前胸和兩頰有異常脂肪增生，並被診斷爲Madelung症候群。以廣泛切除的方式分離顏面神經的主幹，並盡可能移除增生的脂肪組織。
結果：
術中發現病人的顏面神經主幹直徑甚至比分支還要小。在仔細的腫瘤切除術後，病人顏面表情活動並無受損，頸部活動範圍增加，呼吸道的症狀也獲得改善。
結論：
顏面神經在被長期壓迫後可能會有病理性的變化但仍能維持其功能。
廣泛性切除對Madelung症候群有其治療的意義與幫助。

並列摘要

Background:
The surgery of large cheek tumors often requires dissection of facial nerve branches and even the facial nerve trunk. In patients with special pathlogical condition, the size of nerve may varied remarkably.
Aim and Objectives:
The experience of treating Madelung syndrome in our hospital and the clinical finding of facial nerve during operation will be shared.
Materials and Methods:
A 34-years-old man had lipomatosis involving bilateral cheeks and neck, as well as anterior chest. During surgery, the facial nerve branches were identified first, but there is
difficulty in identifying the facial nerve trunk.
Results:
The diameter of trunk of facial nerve was about one third of the size of frontozygomatic branch, but in the usual position and it was tortuous after removal of tumor.
After surgery, the patient could close the eye completely. This proved that the thin, filamentous structure was really the facial nerve trunk and it had been well preserved.
Conclusion:
The facial nerve trunk can be very thin after chronic stretching in a pathological condition.

並列關鍵字

lipomatosis ； madelung syndrome ； facial nerve