【作者】 李德志； 刘松； 苏迪娅； 王彬彬； 庄园； 万虹；

【Author】 Li Dezhi;Liu Song;Su Diya;Wang Binbin;Zhuang yuan;Wan Hong;Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University;

【机构】 首都医科大学附属北京天坛医院神经外科； 首都医科大学北京市神经外科研究所；

【摘要】 目的探讨经乳突面神经减压术治疗颞骨骨折致创伤性面瘫的手术方式和治疗效果。方法回顾性分析2016年1月～2017年9月间在北京天坛医院神经外科接受手术治疗的24例因颞骨骨折致创伤性面瘫患者的临床特点、治疗方法及预后。全部患者为全瘫或接近全瘫,全部行经乳突行面神经减压术。结果面神经损伤位于膝状神经节至锥曲段,表现为神经挫伤、水肿肿胀,部分断裂伤少见。术后随访4～18个月,依据House-Brackmann(HB)面神经功能评分标准,恢复到I级患者3例,II级的患者有16例,III级患者有4例,IV级患者有1例。结论经乳突面神经减压术治疗颞骨骨折致创伤性面瘫患者,可以取得满意的疗效。更多还原

【Abstract】 Objective To assess the value of transmastoid facial nerve decompression on traumatic facial paralysis due to temporal bone fracture.Methods Twenty-four cases of traumatic facial paralysis due to temporal bone fracture from January 2016 to September 2017,were retrospectively reviewed on the clinical manifestations,operative methods and follow-up results.The patients,who were total or near total facial paralysis,were operated between 3 weeks and 5 months after trauma,most of them operated in 2 months.All patients were treated with transmastoid facial nerve decompression.Results The injury located between the geniculate ganglion and the pyramidal segment.Most of them are nerve edema and contusion.Disruption or laceration of facial nerve was rare.In the follow-up of these patients lasting 4 to 18 months all the patients attained satisfactory outcome.The House-Brackmann facial nerve grade was assessed.3 cases were at I scale of House-Brackmann’s facial nerve function,16 cases II scale,4 cases III scale and 1 case IV scale.Conclusions Most traumatic facial paralysis due to temporal bone fracture may be partly or completely recovered with transmastoid facial nerve decompression.更多还原