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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n t检验。n 结果:术后随访1年,手术前后患侧口角移动距离[ΔT-Cn 术前为(-1.2±3.1)mm,ΔT-Cn 术后为(6.1±3.5)mm]差异有统计学意义(n t=-31.1,n 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(n t=-38.1,n 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(n t值分别为-35.8、-29.1、-41.3、-43.9,n P值均<0.01)。n 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。“,”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, n t=-31.1, n P<0.01), ipsilateral FaCE (preoperatively: (29.4±14.1), postoperatively: (57.6±23.4),n t=-38.1, n P<0.01), eFACE score (Composite scoren t=-35.8, Static score n t=-29.1, Dynamic score n t=-41.3,Midface score n t=-43.9, all n P<0.01), respectively.n 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.