中华耳科学杂志Issue(3)：391-395,5.DOI:10.3969/j.issn.1672-2922.2014.03.010
颞骨岩部胆脂瘤切除术及面神经保护和修复
Protection and Repair of Facial Nerve during Resection of Petrous Bone Cholesteatoma
摘要
Abstract
Objective To discuss issues of facial nerve protection during surgery and recovery of facial nerve function after surgery. Methods This was a retrospective study on 79 cases treated for petrous bone cholesteatoma from 1/1/00 to 31/12/12 by PLA General Hospital otolaryngologists. Facial nerve decompression, primary end-to-end anastomosis, great auricu-lar nerve grafting or facial-hypoglossal anastomosis were adopted for restoration of facial nerve function. Facial nerve func-tion was assessed according to House-Brackmann(H-B) Grade. Results The most common location of facial nerve injury was in the labyrinth segment. Facial nerve re-animation methods included facial nerve decompression (n=48), end-to-end anas-tomosis (n=5), rerouting (n=3), greatre auricular nerve grafting (n=3), facial-hypoglossal nerve anastomosis (n=10), and others (n=10). The facial nerve function was assessed before and after surgery. 48 patients were followed up more than 1 year.Among them,29 patients underwent facial nerve decompression , 22 recovered to H-B I, 2 recovered to H-BⅡ,1 re-covered to H-BⅢ,3 recovered to H-BⅣ, and 1 recovered toⅤ. Of the 4 patients who underwent end-to-end anastomosis, 1 recovered to H-BⅡand 3 recovered to H-BⅢ. Of the 3 patients who underwent facial nerve rerouting, 2 recovered to H-BⅢ,and 1 recovered to H-BⅣ. Of the 2 patients treated with greater auricular nerve grafts, 1 recovered to GradeⅣ, and 1 recovered to Grade Ⅴ. Of the 7 patients receiving facial-hypoglossal nerve anastomosis treatment, 1 recovered to GradeⅢ,4 recovered to GradeⅣ,and 2 recovered to GradeⅤ. Facial function remained unchanged in the 3 cases with no treatment. Conclusions During petrous bone cholesteatoma surgeries, surgeons should protect the facial nerve carefully. When facial nerve injury is noticed, various methods can be used for immediate repair.关键词
岩部胆脂瘤/耳外科手术/面神经麻痹Key words
Petrous bone cholesteatoma/Otologic surgical procedure/Facial paralysis分类
医药卫生引用本文复制引用
韩维举,王若雅,申卫东,刘军,戴朴,杨仕明,韩东一..颞骨岩部胆脂瘤切除术及面神经保护和修复[J].中华耳科学杂志,2014,(3):391-395,5.基金项目
国家自然科学基金面上项目 （）
