不同病因的周围性面神经麻痹外科治疗分析  

Surgical treatment to facial nerve paralysis of different pathogeny

作　　者：伊海金[1] 刘丕楠[1] 郭泓[1] 王春红[1] 倪富强[1] 

机构地区：[1]首都医科大学附属北京天坛医院耳鼻咽喉科,北京100050

出　　处：《临床耳鼻咽喉头颈外科杂志》2011年第4期154-157,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨不同病因的周围性面神经麻痹患者外科治疗的相关问题。方法:面神经麻痹患者37例,病因包括:贝尔面瘫5例,颞骨骨折20例,中耳乳突炎4例,内耳道面神经肿瘤3例,颅脑颌面手术损伤5例,针对不同病因采取相应外科治疗方式。结果:H-B分级Ⅰ～Ⅱ级恢复率:贝尔面瘫80%,颞骨骨折80%,中耳乳突炎100%;内耳道面神经肿瘤术后1例由Ⅳ级改善至Ⅲ级,2例术后无明显变化;颅脑颌面手术损伤行面-舌吻合者4例由Ⅴ级改善至Ⅲ级3例,Ⅳ级1例,行瘢痕切除+面神经探查减压术者1例由Ⅴ级改善至Ⅳ级。结论:针对不同病因导致的面神经麻痹,选择合适的手术治疗方法,可以取得良好效果。Objective：To evaluate the surgical treatment to facial nerve paralysis of different pathogeny.Method：Thirty-seven patients were reviewed,including Bell′s Palsy（5 patients）,temporal bone fracture（20 patients）,media otitis（cholesteatoma）（4 patients）,facial neuroma and cranio-maxilly-facial operation trauma（8 patients）.All the patients were treated by different surgical methods according different pathogeny.Result：The mean percentage facial function improvement（House-Brackmann Grade Ⅰ-Ⅱ）was 80%to Bell′s Palsy and temporal bone fracture,100% to media otitis（cholesteatoma）.Facial function of three patients improved from House-Brackmann Grade Ⅳ to Ⅲ,two patients had no obvious improvement about facial neuroma;three patients improved from Grade V to Ⅲ,one improved to Ⅳ about cranio-maxilly-facial operation trauma.Conclusion：Patients of facial nerve paralysis got better curative effect if treated by proper surgical therapy according different pathogeny.

关 键 词：面神经麻痹 颞骨骨折 外科治疗 

分 类 号：R745.12[医药卫生—神经病学与精神病学]