Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2020, Vol. 34 ›› Issue (1): 20-24.doi: 10.6040/j.issn.1673-3770.1.2019.054

• Clinical Report • Previous Articles     Next Articles

Surgical treatment of iatrogenic facial paralysis

Yuxin TIAN,Jingjing WANG,Hui WANG,Yaqin WU,Haibo SHI,Zhengnong CHEN*()   

  1. Department of Otolaryngology Head and Neck Surgery, Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China
  • Received:2019-09-18 Online:2020-01-20 Published:2020-03-06
  • Contact: Zhengnong CHEN E-mail:jassey@126.com

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Abstract: Objective

To evaluate the surgical treatment of iatrogenic facial paralysis and discuss its cause, treatment and therapeutic effect.

Methods

A retrospective study of 21 iatrogenic facial paralysis cases who underwent ear surgery in the ear, nose, and throat (ENT) Department between 2015 and 2017.

Results

Of those that underwent middle ear surgery, 10 iatrogenic facial nerve injuries cases were observed in the following segments: the horizontal segment in 7 cases, the pyramidal segment in 2 cases, and the vertical segment in 1 case. After evaluating the degree of damage, decompression was performed in 7 cases, and facial nerve-great auricular nerve transplantation in 3 cases. The other 11 cases with facial paralysis after acoustic neuroma surgery underwent hypoglossal-facial anastomosis. Sixteen cases (about 76%) achieved HB Ⅰ-Ⅲ one year after surgery.

Conclusions

Although scientific and technological developments have reduced the probability of facial nerve injuries, iatrogenic facial paralysis cannot be entirely avoided. Clinical doctors need to have excellent anatomical knowledge and correct operation technique to prevent iatrogenic facial paralysis. Once iatrogenic facial paralysis occurs, early diagnosis and treatment are required to achieve ideal outcomes of patients' facial nerve function.

Key words: Iatrogenic facial paralysis, Middle ear surgery, Surgical treatment, Therapeutic effect

CLC Number: 

  • R764

Fig.1

Facial nerve swelling"

Fig.2

Facial nerve rupture (the dotted line is the missing part of the facial nerve)"

Table 1

The surgical timing and recovery of facial paralysis"

损伤原因 例数 术前面神经功能 手术治疗时机 术后面神经功能
中耳手术
  乳突改良根治术 9 Ⅳ级7例 一周内 Ⅰ级2例
Ⅴ级1例 Ⅱ级5例
Ⅵ级1例 Ⅲ级1例
Ⅳ级1例
  人工耳蜗植入术 1 Ⅳ级1例 一周内 Ⅰ级1例
听神经瘤切除术 11 Ⅴ级6例 保守治疗半年至一年，面神经功能无改善后 Ⅲ级7例
Ⅵ级5例 Ⅳ级4例
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