面神经减压治疗周围性面瘫32例临床分析  

Facial nerve decompression for peripheral facial paralysis in 32 cases

作　　者：沈志森[1] 张宇园[1] 王侃[1] 沈毅[1] 

机构地区：[1]宁波市医疗中心李惠利医院耳鼻咽喉-头颈外科,宁波315040

出　　处：《中华耳科学杂志》2008年第4期428-430,共3页Chinese Journal of Otology

摘　　要：目的探讨不同原因的周围性面瘫手术时机及临床疗效。方法对32例不同原因所致周围性面瘫病人行CT扫描,根据CT扫描结果行不同进路的面神经减压手术,术后随访半年至2年,按House-Brackmann分级法(H-B分级法)评判面神经功能恢复程度。结果32例中17例颞骨骨折面瘫(Ⅴ级2例,Ⅵ级15例),据面肌电图动态观察,伤后2周内手术者13例,术后随访0.5～2.0年,面神经功能恢复至H-BⅠ～Ⅱ级11例,达84.6%;伤后3周手术3例,恢复至Ⅱ级2例,Ⅲ级1例;伤后8周手术1例,仅恢复至Ⅵ。医源性面瘫(Ⅵ级)患者2例,分别在伤后2周和3周手术并恢复至Ⅱ级和Ⅲ级。13例中耳乳突病变者均在1周内手术,恢复至Ⅰ、Ⅱ、Ⅲ级的分别为8、2、3例。结论面神经减压术治疗颞骨骨折及中耳乳突胆脂瘤致周围性面瘫是有效的,且应根据面神经电图动态观察,采取积极的治疗措施。Objective To explore the operation indications,techniques and surgical efficacy for peripheral facial nerve paralysis with different causes and injury locations.Methods Thirty-two cases of peripheral facial paralysis were treated with selective facial nerve decompression via different surgical approaches.After 0.5 year to 2 years’ follow up,the recovered functions of facial nerve were judged by House and Brackmann(H-B) grading system.Results In 17 pa-tients with peripheral facial paralysis caused by trauma,...

关 键 词：面神经麻痹 颞骨骨折 面神经减压术 外科 胆脂瘤中耳炎 

分 类 号：R745.12[医药卫生—神经病学与精神病学]