跨颅内外面神经桥接吻合术治疗面神经损伤的临床分析  

Clinical analysis of transcranial facial nerve bridging with interpositional graft for the treatment of facial nerve injury

作　　者：张玮洵 高震 马梦叶[1,2] 吕霁寒 贾贤浩 赵卫东 袁雅生[1,2] ZHANG Weixun;GAO Zheng;MA Mengye;LV Jihan;JIA Xianhao;ZHAO Weidong;YUAN Yasheng(ENT Institute and Department of Otorhinolaryngology,Eye&ENT Hospital,Fudan University,Shanghai,200031,China;Lateral Skull Base Diagnosis and Treatment Center,Eye Ear Nose and Throat Hospital,Fudan University)

机构地区：[1]复旦大学附属眼耳鼻喉科医院耳鼻喉科,上海200031 [2]复旦大学附属眼耳鼻喉科医院侧颅底肿瘤中心

出　　处：《临床耳鼻咽喉头颈外科杂志》2024年第5期376-379,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：“科技创新行动计划”“一带一路”国际合作项目(No:20410740600);促进市级医院临床技能与临床创新能力三年行动计划(No:SHDC2020CR1049B)。

摘　　要：目的:通过回顾性研究对于接受跨颅内外面神经桥接吻合术的患者的面神经功能损伤治疗的效果进行分析。方法:对复旦大学附属眼耳鼻喉科医院2017至2022年进行了跨颅内外面神经吻合术的27例面神经功能损伤患者进行回顾性分析。主要收集的数据包括患者的年龄、性别、原发性病变、损伤位置、面瘫到手术的间隔时间以及术前和术后的面神经功能House-Brackmann(HB)评分,并对患者术前术后的平均HB评分进行了统计学比较。结果:27例患者中男17例,女10例;手术时的平均年龄为(42.50±3.38)岁;原发侧颅底疾病包括外伤3例、肿瘤22例和感染2例;面瘫的持续时间6个月~5年。统计发现进行了跨颅内外面神经吻合术的患者的术后平均HB评分(3.750±0.183)较术前(4.875±0.168)明显下降。面神经功能良好患者比例从术前的7.4%上升到42.9%。结论:面神经跨颅内外端端吻合术后对于改善的面神经损伤患者的面神经功能都有显著效果。目前仍需要进一步的研究来评估该手术的长期效果,并确定最佳的患者选择标准和术后康复策略。Objective To retrospectively analyze the effectiveness of transcranial facial nerve bridging in the treatment of facial nerve dysfunction.Methods A retrospective analysis was conducted on 27 patients with facial nerve dysfunction who underwent transcranial facial nerve bridging at the Eye,Ear,Nose,and Throat Hospital affiliated with Fudan University from 2017 to 2022.The main collected data includes the patient's age,gender,primary lesion,damaged location,interval from facial paralysis to surgery,and preoperative and postoperative House-Brackmann(HB)scale for facial nerve function.Statistical comparisons were made between the average HB level of patients before and after surgery.Results A total of 27 patients included 17 males and 10 females.The average age of patients during surgery is(42.50±3.38)years old.Primary lateral skull base diseases include trauma(n=3),tumors(n=22),and infections(n=2).The duration of facial paralysis varies from 6 months to 5 years.Statistics analysis has found that the average postoperative HB score of patients who underwent transcranial facial nerve bridging was significantly lower at(3.750±0.183)compared to preoperative(4.875±0.168).The proportion of patients with good facial nerve function increased significantly from 7.4%before surgery to 42.9%after surgery.Conclusion Transcranial facial nerve bridging surgery with interpositional graft has a significant effect on improving facial nerve function in patients with facial nerve injury.Further research is still needed to evaluate the long-term effectiveness of this surgery,to determine the optimal patient selection criteria and postoperative rehabilitation strategies.

关 键 词：面神经损伤 神经移植 跨颅内外面神经移植 

分 类 号：R722.14[医药卫生—儿科]