胆脂瘤型中耳炎并发面神经麻痹的临床诊治体会  

Experience of cholesteatoma with facial paralysis clinical diagnosis and treatment

作　　者：万良财[1] 李永贺[1] 谢南屏[1] 刘双秀[1] 陈帅君[1] 龚剑[1] 陈浩[1] 

机构地区：[1]南方医科大学珠江医院耳鼻咽喉科,广东广州510282

出　　处：《中国现代医学杂志》2010年第20期3127-3129,3134,共4页China Journal of Modern Medicine

摘　　要：目的探讨胆脂瘤型中耳炎并面瘫的手术处理及术后面神经功能恢复情况。方法回顾性分析该院1998年1月～2008年6月36例因胆脂瘤型中耳炎并面瘫而行面神经减压手术的完整病例资料,33例行开放式乳突根治术,3例行闭合式乳突根治术,随访2年,以House-Brackmann(H-B)分级法作为疗效评估标准。结果 34例面神经骨管不同程度破坏,大部分位于水平段(22例),锥曲段4例,垂直段3例,水平段与锥段同时受损4例,水平段、锥段、垂直段全部受损仅1例。36例面神经功能均有不同程度恢复,80%恢复至H-BⅡ级以上,92%恢复至Ⅲ级以上。结论胆脂瘤型中耳炎并面瘫,面神经减压是一种有效的治疗手段,手术应尽早实施,面瘫后1个月内手术面神经功能恢复较好。Objective To investigate surgery of cholesteatoma with facial paralysis, and the recovery of neurological function after surgery.MethodsRetrospective analysis the complete clinical data of 36 cases of cholesteatoma with facial paralysis who had facial nerve decompression surgery in our hospital from January 1998 to June 2008, 33 cases were underwent open radical mastoidectomy, three cases of closed radical mas-toidectomy, 36 cases were followed up for 2 years, House-Brackmann （H-B） system was used to evaluate the recovery of facial nerve function. Results Facial canal were were damaged in varying degrees of the 34 cases, the tympanic segment was the most common site of bone destruction （22 cases）, 4 cases were at the cone segment, 3 cases were at the vertical segment, 4 cases were both at the tympanic and the cone segment, only 1 case was damaged at tympanic, cone, vertical segment at the same time. 36 cases of facial nerve function restoration of varying degrees, 80% cases reached H-BⅡ, 92% cases reached H-BⅢ. Con-clusionFacial nerve decompression is an effective treatment for cholesteatoma with facial paralysis, it is recommended that surgery decompression be carried out as soon as possible since a better prognosis is obtained if it is performed within one months after facial paralysis.

关 键 词：中耳炎 化脓性 面神经麻痹 胆脂瘤 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]