文档介绍：外伤性面瘫的手术治疗
许耀东郑亿庆龙桦陈洁珠
(中山医科大学附属孙逸仙纪念医院耳鼻喉科;广州, 510120)
摘要目的:探讨外伤性面瘫适当的处理方法。方法:对12例外伤性面瘫的病例施行手术治疗,损伤部位于面神经迷路段及膝状神经节周围3例次、水平段6例次、垂直段4例次、颅内段1例次。经乳突、上鼓室进路10例,经颅中窝、乳突联合进路2例。结果:术后随访半年~3年。面瘫Ⅰ级恢复7例,Ⅱ级恢复2例,Ⅲ级恢复2例,Ⅳ级恢复1例。结论:外伤性面瘫应及早手术,乳突上鼓室进路基本上可暴露膝状神经节及迷路段远端,但术野狭窄,对膝状神经节减压不够完全,且影响听力。对于损伤膝状神经节以上部位者,应采用颅中窝、乳突进路,并根据损伤性质,选取不同的手术方法。
主题词面神经麻痹/外科学;头部损伤/外科学
中图号 R
Surgical Treatment of Traumatic Facial Paralysis
Xu Yaodong Zheng Yiqing LongHua Chen Jiezhu
(Department of ENT, Sun Yat-sen Memorial Hospital,Sun Yat-sen University of Medical Sciences, Guangzhou,510120)
Abstract Objective:To investigate proper treatment for traumatic facial :12 cases of traumatic facial paralysis undergone surgical treatment. 3 cases showed injuries to the labyrinthine segment of nerve and geniculate ganglion, 6 cases to tympanic segment, 4 cases to mastoid segment and 1 case to intracranial segment. Among these cases trans-mastoid /attic approachwas used in 10 patients and trans-mastoid /middle cranial fossa approach in 2 cases. Results:All cases have been followed up 6 months to 3 years. Copmlete recovery appeared in 7 of the cases and partial recovery in 5 cases (gradeⅡin 2, gradeⅢin 2, grade IV in 1).Conclusions:Traumatic facial paralysis should be treated surgically in -mastoid /attic approach can expose geniculate ganglion and distal part of the labyrinthine segment of