超声引导下神经阻滞治疗Hunt综合征:病例报告及文献回顾  

Ultrasound-guided nerve block for Hunt syndrome:a case report and literature review

作　　者：李富波 龚格格 任长和 欧册华 LI FuBo;GONG Gege;REN Changhe;OU Chehua(Department of Pain,Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China;Department of Physical Diagnosis,Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China)

机构地区：[1]西南医科大学附属医院疼痛科,四川泸州646000 [2]西南医科大学附属医院物理诊断科,四川泸州646000

出　　处：《西南医科大学学报》2020年第1期58-61,共4页Journal of Southwest Medical University

基　　金：泸州市卫生健康委员会课题(编号:2019-50)。

摘　　要：报告1例多颅神经受累的Hunt综合征,通过超声引导下神经阻滞治疗,并对Hunt综合征的相关治疗进行文献回顾。患者,男,65岁,因左耳、耳周、左侧颜面部疼痛10 d为主诉入院。临床表现为左耳、耳周、左侧颜面部及咽喉部疼痛,眩晕,左周围性面瘫,疼痛性质为烧灼痛、触痛(神经病理性疼痛),受累的三叉神经、舌咽神经及上颈段外周神经(C1-3)浅感觉减退;影像学检查:左侧中耳乳突炎,左侧耳廓根部肿胀。经过抗病毒、营养神经及超声引导下面神经、翼腭窝、颈椎小关节及星状神经阻滞,患者颜面部、耳周、颈部疼痛明显改善,随访1月无疼痛,轻微面瘫;随访3个月,无面瘫,已恢复日常工作。本文结合本例患者进行了Hunt综合征的相关文献复习,对Hunt综合征的相关治疗等内容进行了回顾,超声引导下的神经阻滞在Hunt综合征治疗中值得推广。We report a case of Hunt syndrome with multiple cranial nerve involvement,who was treated with ultrasound-guided nerve block,and make a literature review on the treatment of Hunt syndrome.The patient,a 65-year-old man,was admitted to the hospital complaining of pain in his left ear,periauricular region,left face,and throat for 10 days.The pain was of neuropathic features of burning feeling and tenderness(neuropathic pain).He also presented with vertigo,left peripheral facial paralysis,and superficial hypoesthesia of the regions innervated by the trigeminal nerve,glossopharyngeal nerve,and peripheral nerves of the upper cervical cord(C1-3).The imaging examination showed left otitis media and mastoiditis and swelling of the base of left auricle.The patient was treated with ultrasound-guided block of the facial nerve,pterygopalatine ganglion,cervical facet joints,and stellate ganglion,as well as antiviral and nerve-nourishing therapies.After treatment,he had significant alleviation of pain in the face,ear,and neck;after 1 month,there was no pain,but with slight facial paralysis;after 3 months,he recovered from facial paralysis and resumed daily work.In this paper,we not only describe this case,but also extend to review the relevant literature of Hunt syndrome,especially focusing on its treatment.In our opinion,ultrasound-guided nerve block shows promise in the treatment of Hunt syndrome.

关 键 词：超声 神经阻滞 HUNT综合征 

分 类 号：R764.1+5[医药卫生—耳鼻咽喉科]