Traumatic facial nerve paralysis dilemma. Decision making and the novel role of endoscope  

作　　者：Mohamed Elkahwagi Mohammed Abdelbadie Salem Waleed Moneir Hassan Allam 

机构地区：[1]ORL-HNS Mansoura university,Egypt

出　　处：《Journal of Otology》2022年第3期116-122,共7页中华耳科学杂志（英文版）

摘　　要：Objective: The management of traumatic facial nerve paralysis(FNP) has remained a controversial issue with conflicting findings arguing between surgical decompression and conservative management.However, recent advances in endoscopic surgery may consolidate the management plan for this condition.Methods: This prospective clinical study included patients with posttraumatic FNP at a tertiary referral center. Patients were categorized in two main groups: surgical and conservative. Indications for surgery included patients with immediate and complete FNP, no improvement in facial function on medical treatment, with electroneurography showing >90% degeneration or electromyography showing fibrillation potential. Patients who did not satisfy this criterion received the conservative approach. The transcanal endoscopic approach(TEA) or endoscopic assisted transmastoid approach was performed for facial nerve decompression in the surgical group.Outcome: The main outcome was facial function improvement, assessed using the House Brackmann grading scale(HBGS) 6 months after surgery, and hearing state assessed using the air bone gap(ABG).Results: The study included 38 patients, of whom 15 underwent had surgical decompression and 23underwent conservative therapy. A significant improvement in facial nerve function from a mean of4.66 ± 0.97 to 1.71 ± 0.69(P = 0.001) and ABG from a median of 30(10-40) to 20(10-25)(P = 0.002)was observed.Conclusion: Decision-making in cases of traumatic FNP is critical. The geniculate ganglion and tympanic segment were the most commonly affected areas in FNP cases. The TEA represents the most direct and least invasive approach for this area.

关 键 词：POSTTRAUMATIC Facial nerve DECOMPRESSION ENDOSCOPIC Transcanal Electrodiagnostic 

分 类 号：R651.3[医药卫生—外科学]