中华耳科学杂志2016，Vol.14Issue(2)：176-180,5.DOI:10.3969/j.issn.1672-2922.2016.02.010
面神经减压术治疗颞骨外伤性面瘫临床分析
Facial never decompression via mastoid-epitympanum approach in patients with traumatic facial paralysis
摘要
Abstract
Objective To study operation indications, optimal timing and final facial function outcomes in patients with traumatic facial paralysis in relation to surgery timing. Methods We performed a retrospective review of 99 cases (102 sides) of tramatic facial paraiysis who underwent facial never depression via a mastoid-epitympanum approach, and ana-lyzed the relation between fracture type and hearing loss. Patients were classified by fracture type and time before surgery and 70 cases (73 sides) with complete data were summarized. The House-Brackmann (H-B) grading scale was used to evalu-ate facial nerve function pre-and post-operation. Spearman test andχ2 test were employed for stastistic analysis. Results Causes of traumatic facial paralysis in this group of cases included traffic accidents (n=55, 58 sides), falls (n=20), crashes (n=17) and others (n=7). Temporal bone fracture was identified in 68 cases (71 sides), including both longitudinal (n=56, 59 sides) and transverse (n=12) fractures. The incidences of conductive hearing loss in cases with longitudinal (37.3%) and transverse (16.7%) fractures were not statistically different (P=0.169). The incidence of sensorineural hearing loss in trans-verse fractures (66.7%) was significantly higher than in longitudinal fractures (P=0.001). Varying degrees of facial function improvement were noticed during following up, and showed no difference among subgroups classified by fracture types (P=0.478), although there was a close relationship between facial nerve function recovery grade and the course of nerve injury (r=0.257, P=0.026). The rate of good recovery to H-B 1 or 2 in patients undergoing decompression surgery within 2 months after trauma was 87.8%(43/49), better than that of patients undergoing late decompression (P=0.032). Conclusion Traffic crashes continue to be the main cause of traumatic facial paralysis. Facial nerve decompression is an effective management for traumatic facial paralysis. Facial function recovery is correlated with the course of facial nerve trauma. Facial nerve de-compression should be carried out as soon as possible and better recovery is expected if the surgery is performed within 2 months.关键词
面神经麻痹/创伤和损伤/手术时机/面神经减压术Key words
Facial paralysis/Wounds and injuries/Optimal timing/Decompression surgery分类
医药卫生引用本文复制引用
唐朝颖,韩维举,张纪帅,张桐,申卫东,刘军,戴朴,杨仕明,韩东一..面神经减压术治疗颞骨外伤性面瘫临床分析[J].中华耳科学杂志,2016,14(2):176-180,5.基金项目
国家自然科学基金面上项目（NO.81170908,81470683）National Natural Science Foundation of China （）
