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作 者:黄少鹏[1] 叶青[1] 林美福[2] 陈娟[1] 王一红[1] 李瑞玉[1]
机构地区:[1]福建医科大学省立临床学院耳鼻咽喉科,福州350001 [2]福建医科大学省立临床学院PET-CT室,福州350001
出 处:《福建医科大学学报》2011年第3期214-217,共4页Journal of Fujian Medical University
摘 要:目的探讨多层螺旋CT(MSCT)扫描及面神经管曲面重建(CPR)在外伤性面瘫中的应用价值。方法对15例外伤性面瘫患者的颞骨行MSCT高分辨率扫描,并通过工作站行CPR,观察面神经损伤平面,并选择相应的手术径路行面神经减压术。结果术前MSCT扫描及CPR提示,3例面神经损伤主要在迷路段及膝状神经节的,采用颅中窝乳突联合径路;12例损伤主要位于膝状神经节以下,选择乳突径路。术中所见与术前CT提示均一致。术后随访6月-5年,15例患者Ⅰ级恢复7例、Ⅱ级恢复7例、Ⅲ级恢复1例。结论 MSCT扫描及CPR能清晰显示面神经管的全貌及其损伤部位,对外伤性面瘫的诊断及手术治疗具有重要意义。Objective To investigate the applied value of multislice spiral CT(MSCT)and Curved planar reformation(CPR) for traumatic facial nerve paralysis and the guidance significance for surgery.Methods 15 cases of traumatic facial nerve paralysis were scanned by MSCT,Post processing images of facial nerve canal were completed by GE Advantage 4.2 work station.Different Surgical approaches of facial nerve decompression were selected according to the injured location described by MSCT and CPR.Results A combined middle fossa and transmastoid approach was chosen in 3 cases whose injured location above geniculate ganglion.A pure transmastoid route was performed in the other 12 cases whose injured location under geniculate ganglion.After 0.5-5 years' follow-up,7 cases recovered to grade Ⅰ according to House-Brackmann facial nerve function scores,7 cases recovered to grade Ⅱ and the other 1 case recovered to grade Ⅲ.Conclusion multislice spiral CT(MSCT) and Curved planar reformation(CPR) could help to study the facial nerve canal and describe precise localization for traumatic facial nerve paralysis,which provide reliable basis for clinical diagnosis and treatment.
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