中华耳科学杂志
中華耳科學雜誌
중화이과학잡지
CHINESE JOURNAL OF OTOLOGY
2014年
2期
296-299
,共4页
方瑾%潘军燕%陈晓红%周水洪%柴亮%杨雪明%王媚%鲍洋洋%钱林荣%李海同
方瑾%潘軍燕%陳曉紅%週水洪%柴亮%楊雪明%王媚%鮑洋洋%錢林榮%李海同
방근%반군연%진효홍%주수홍%시량%양설명%왕미%포양양%전림영%리해동
面神经%减压%面神经麻痹%颞骨骨折%中耳胆脂瘤
麵神經%減壓%麵神經痳痺%顳骨骨摺%中耳膽脂瘤
면신경%감압%면신경마비%섭골골절%중이담지류
Facial nerve%Decompression%Facial paralysis%Injury fractures%Cholesteatoma
目的：探讨不同面神经疾病致周围性面瘫行面神经减压手术的疗效。方法对9例外伤性面瘫、3例贝尔氏面瘫及3例中耳胆脂瘤所致的周围性面瘫，经乳突-颞下迷路上隐窝进路面神经显微减压手术，术后随访0.5～2年，按面瘫H-B分级法评估面神经功能恢复程度。结果9例颞骨骨折面瘫(Ⅳ级2例，V级6例，Ⅵ级1例)，伤后2～4周手术5例，术后面神经功能恢复I级4例，Ⅱ级1例；伤后5～8周手术3例，面神经功能恢复Ⅱ级2例，Ⅲ级1例；伤后9～12周手术1例，恢复Ⅳ级。3例贝尔面瘫(Ⅳ级1例，V级2例),9～12周手术2例，均Ⅱ级恢复，12周后手术1例，为Ⅲ级恢复；3例中耳胆脂瘤（Ⅲ级2例，Ⅳ1例）在1～2周内手术，均I级恢复。结论对于不同原因所致周围性面瘫患者，选择合适的时机行面神经减压术，多能取得良好疗效。
目的：探討不同麵神經疾病緻週圍性麵癱行麵神經減壓手術的療效。方法對9例外傷性麵癱、3例貝爾氏麵癱及3例中耳膽脂瘤所緻的週圍性麵癱，經乳突-顳下迷路上隱窩進路麵神經顯微減壓手術，術後隨訪0.5～2年，按麵癱H-B分級法評估麵神經功能恢複程度。結果9例顳骨骨摺麵癱(Ⅳ級2例，V級6例，Ⅵ級1例)，傷後2～4週手術5例，術後麵神經功能恢複I級4例，Ⅱ級1例；傷後5～8週手術3例，麵神經功能恢複Ⅱ級2例，Ⅲ級1例；傷後9～12週手術1例，恢複Ⅳ級。3例貝爾麵癱(Ⅳ級1例，V級2例),9～12週手術2例，均Ⅱ級恢複，12週後手術1例，為Ⅲ級恢複；3例中耳膽脂瘤（Ⅲ級2例，Ⅳ1例）在1～2週內手術，均I級恢複。結論對于不同原因所緻週圍性麵癱患者，選擇閤適的時機行麵神經減壓術，多能取得良好療效。
목적：탐토불동면신경질병치주위성면탄행면신경감압수술적료효。방법대9예외상성면탄、3례패이씨면탄급3례중이담지류소치적주위성면탄，경유돌-섭하미로상은와진로면신경현미감압수술，술후수방0.5～2년，안면탄H-B분급법평고면신경공능회복정도。결과9례섭골골절면탄(Ⅳ급2례，V급6례，Ⅵ급1례)，상후2～4주수술5례，술후면신경공능회복I급4례，Ⅱ급1례；상후5～8주수술3례，면신경공능회복Ⅱ급2례，Ⅲ급1례；상후9～12주수술1례，회복Ⅳ급。3례패이면탄(Ⅳ급1례，V급2례),9～12주수술2례，균Ⅱ급회복，12주후수술1례，위Ⅲ급회복；3례중이담지류（Ⅲ급2례，Ⅳ1례）재1～2주내수술，균I급회복。결론대우불동원인소치주위성면탄환자，선택합괄적시궤행면신경감압술，다능취득량호료효。
Objcetive To report results of facial nerve decompression for peripheral facial palsy caused by different facial never diseases.Methods Etiologies in this group included trauma (n=9), Bell’s palsy (n=3) and cholesteatoma in middle ear (n=3).All patients were treated with facial nerve decompression via transmastoid, subtemporal or supralabyrinthine approach-es.The House-Brackmann facial nerve grade was assessed during the 0.5 to 2 years follow up.Results Among the 9 traumat-ic facial palsy patients caused by temporal bone fracture, 5 received surgery within 2 to 4 weeks and achieved grade I (n=4) or II (n=1) facial function;3 received surgery within 5 to 8 weeks and achieved gradeⅡ(n=2) orⅢ(n=1) facial function;and 1 received the operation within 9 to 12 weeks after the injury and achieved only gradeⅣfacial function.Two patients with Bell ’s palsy were operated on within 9 to12 weeks and achieved grade I or II facial function. One Bell’s palsy patient achieved gradeⅢfacial function after receiving surgery 12 weeks after disease onset. The 3 cases of middle ear cholesteatoma were oper-ated upon in 1 to 2 weeks and all achieved grade I facial function. Conclusions Appropriate timing and facial nerve decom-pression operations based on the etiologies can lead to good facial function results.
