经颅中窝和经乳突颞下迷路外入路面神经减压术治疗颞骨骨折性面瘫临床对比研究  

A comparative study on the treatment of facial paralysis caused by temporal bone fracture by facial nerve decompression with through the middle cranial fossa and external approach through subtemporal labyrinth of mastoid

作　　者：刘晖 刘伟 Liu Hui;Liu Wei(Xiangtan City Medical and Health College,Hunan,Xiangtan 411100;The Central Hospital of Xiangtan City,Hunan,Xiangtan)

机构地区：[1]湘潭市医卫职业技术学院,湖南湘潭411100 [2]湘潭市中心医院,湖南湘潭411100

出　　处：《中国社区医师》2020年第4期77-78,共2页Chinese Community Doctors

摘　　要：目的:比较经颅中窝和经乳突颞下迷路外入路面神经减压术治疗颞骨骨折性面瘫的临床效果。方法:2016年1月-2017年1月收治行面神经减压术的颞骨骨折性面瘫患者52例,随机分为两组,各26例。对照组经颅中窝手术入路,观察组经乳突颞下迷路外入路。评估患者面神经功能分级变化、临床治愈率及不同手术时间临床治愈率。结果:两组治愈率比较,差异无统计学意义(P>0.05)。所有患者膝状神经节损伤、垂直段损伤、水平段损伤、水平段+膝状神经节损伤患者术后面神经功能Ⅰ~Ⅱ级占比接近,差异无统计学意义(P>0.05)。所有患者不同手术时间临床治愈率比较,差异有统计学意义(P<0.05)。结论:面神经减压术是临床治疗颞骨骨折性面瘫的经典术式,经颅中窝或经乳突颞下迷路外入路均可达到满意手术疗效,其中经乳突颞下迷路外入路实施面神经减压术安全性较好,而且操作简单。Objective:To explore the effect of facial nerve decompression with through the middle cranial fossa and external approach through subtemporal labyrinth of mastoid in treatment of facial paralysis caused by temporal bone fracture.Methods:From January 2016 to January 2017,52 patients with facial paralysis caused by temporal bone fracture treated with facial nerve decompression were selected and randomly divided into two groups of 26 cases in each.The control group was treated by through the middle cranial fossa approach,the observation group was treated by external approach through subtemporal labyrinth of mastoid.We evaluated the changes of facial nerve function,clinical cure rate and clinical cure rate in different operation time.Results:In the patients with knee ganglion injury,vertical segment injury,horizontal segment plus knee ganglion injury and horizontal segment injury,the proportion of gradeⅠtoⅡnerve function after operation was close,and the difference was not statistically significant(P>0.05).There was no significant difference in cure rate between the two groups(P>0.05).There was significant difference in the clinical cure rate of different operation time(P<0.05).Conclusion:Facial nerve decompression is a classic operation for the treatment of facial paralysis caused by temporal bone fracture,all of through the middle cranial fossa and external approach through subtemporal labyrinth of mastoid can achieve satisfactory results,among them,the safety of facial nerve decompression with external approach through subtemporal labyrinth of mastoid is better,and the operation is simple.

关 键 词：颞骨骨折 面瘫 面神经减压术 手术入路 

分 类 号：R651.3[医药卫生—外科学]