CAJ | 학술논문

目的总结由于中耳炎、Hunt综合征、肿瘤及理化损伤4种常见耳源性疾病导致的面神经麻痹手术治疗的经验,增加对手术治疗耳源性面神经麻痹的认识.方法回顾性分析1991年10月至2007年3月间由于上述4种耳部疾病导致面神经麻痹的24例患者的临床资料.面神经功能评估采用House-Brackman分级.结果 24例患者中男10例,女14例;年龄14～82岁,平均44.5岁.耳部病变包括:胆脂瘤中耳炎12例(其中合并Hunt综合征1例),慢性单纯性化脓性中耳炎3例,急性中耳炎2例,Hunt综合征3例,理化因素损伤2例,中耳肿瘤2例.治疗前House·Brackman分级Ⅱ级3例,Ⅲ级5例,Ⅳ级13例,V级3例.手术行面神经减压术7例,病变切除+面神经减压术12例,病变切除未处理面神经4例,病变切除+切除面神经1例.术后随访1个月到8年,Ⅱ级以下者均随访6个月以上;恢复I级4例,Ⅱ级10例,Ⅲ级6例,Ⅳ级2例,V级l例,1例因癌症切除面神经为Ⅵ级.结论及时去除病灶、行面神经减压是治疗耳源性面神经麻痹的有效方法,彻底地清理病灶是手术治疗耳源性面神经麻痹获得良好术后效果的基础.
목적 총결유우중이염、Hunt종합정、종류급이화손상4충상견이원성질병도치적면신경마비수술치료적경험,증가대수술치료이원성면신경마비적인식.방법 회고성분석1991년10월지2007년3월간유우상술4충이부질병도치면신경마비적24례환자적림상자료.면신경공능평고채용House-Brackman분급.결과 24례환자중남10례,녀14례;년령14～82세,평균44.5세.이부병변포괄:담지류중이염12례(기중합병Hunt종합정1례),만성단순성화농성중이염3례,급성중이염2례,Hunt종합정3례,이화인소손상2례,중이종류2례.치료전House·Brackman분급Ⅱ급3례,Ⅲ급5례,Ⅳ급13례,V급3례.수술행면신경감압술7례,병변절제+면신경감압술12례,병변절제미처리면신경4례,병변절제+절제면신경1례.술후수방1개월도8년,Ⅱ급이하자균수방6개월이상;회복I급4례,Ⅱ급10례,Ⅲ급6례,Ⅳ급2례,V급l례,1례인암증절제면신경위Ⅵ급.결론 급시거제병조、행면신경감압시치료이원성면신경마비적유효방법,철저지청리병조시수술치료이원성면신경마비획득량호술후효과적기출.
objective To study the character of facial nerve palsy due to four difierent auris diseases including chronic otitis media,Hunt syndrome,tumor and physical or chemical factors,and to discuss the principles of the surgical management of otogenic facial nerve palsy.Methods The clinical charaeters of 24 patients with otogenic facial nerve palsy because of the four different auris diseases were retrospectively analyzed,all the cases were performed surgical management from October 1991 to March 2007.Facial nerve function Was evaluated with House-Brackmann(HB) grading system.Results The 24 patients including 10 males and 14 females were analysised,of whom 12 cases due to cholesteatoma,3 cases due to chronic otitis media,3 cases due to Hunt syndrome,2 cases resulted from acute otitis media,2 cases due to Dhysical or chemical factors and 2 cases due to tumor.All cases were treated with operations included facial nerve decompression,lesion resection with facial nerve decompression and lesion resection without facial nerve decompression,I patient'S facial nerve was resected because of the tumor.According to HB grade system,I degree recovery was attained in 4 cases,while Ⅱ degree in 10 cases,Ⅲ degree in 6 cases,Ⅳ degree in 2 cases,V degree in 2 cases and Ⅵ degree in 1 case.Conclusions Removing the lesions completely Was the basic factor to the surgery of otogenie facial palsy,moreover,it was important to have facial nerve decompression soon after lesion removal.