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目的：探讨不同程度失神经支配的面神经和面肌的病理变化，为判断预后和制定治疗方案提供参考。方法：制作豚鼠面神经不同损伤程度的面神经麻痹实验模型，应用透射电镜扫描电镜观察面神经和口轮匝肌超微结构变化。结果：压榨面神经５ｓ组只见髓鞘轻度病变，肌纤维无异常改变；３０ｓ组髓鞘和轴突及肌纤维都呈重度病理改变；１５ｓ组神经纤维和肌纤维处于前两组改变的中间状态。结论：面神经失神经支配程度越重，面神经纤维和面肌肌纤维的病理变化越重，轻、中度失神经支配的面瘫是可逆性面神经麻痹，重度失神经支配的颅骨外伤性面瘫，早期行面神经减压术，有利于面神经功能恢复。
OBJECTIVE: To investigate the pathological changes of facial nerve and facial muscle at different degrees of denervation, and to provide a reference for judging prognosis and developing treatment plan. Methods: The experimental model of facial paralysis caused by different degrees of facial nerve injury in guinea pigs was made. The ultrastructural changes of the facial nerve and orbicularis oris muscle were observed by transmission electron microscope. Results: There was no obvious change of myofibers in myelin sheaths in 5s group of facial nerve after pressing for 5s. The myelin, axons and myofibers in 30s group showed severe pathological changes. The nerve fiber and muscle fiber in 15s group were in the intermediate state of the first two groups. CONCLUSION: The more denervated facial nerve, the heavier the pathological changes of facial nerve fiber and facial muscle fiber are. The mild and moderate denervated facial paralysis is reversible facial paralysis, severe denervation dominated skull traumatic facial paralysis, early facial nerve Decompression surgery is conducive to facial nerve function recovery.