儿童乳突-颞下迷路外面神经减压术8例临床分析

doi:10.6040/j.issn.1673-3770.0.2021.405

摘要/Abstract

摘要： 目的探讨儿童颞骨骨折性面神经麻痹经乳突-颞下迷路外径路面神经减压术的疗效。方法 8例颞骨骨折性面神经麻痹患者分别在病情出现的1个月内,行经乳突-颞下迷路外径路面神经减压术,部分同期行听骨链重建术,随访1~2年,评估听力及面神经功能(H-B)程度。结果术前H-B Ⅴ级7例、Ⅳ级1例,术后恢复Ⅰ级5例、Ⅱ级3例;术前2例听力分别为中度、重度传导性耳聋,术后分别恢复至正常、轻度传导性耳聋;术前1例听力正常,术后听力无损伤;余5例术前听力为重度、极重度感音神经性耳聋。结论外伤后1个月内经乳突-颞下迷路外径路面神经减压术,可同时获得面神经功能及听力的满意恢复。

关键词: 颞骨骨折, 面神经麻痹, 减压术, 儿童, 面神经功能

Abstract: Objective To explore the curative effect of the external transmastoid-subtemporal labyrinth approach for facial nerve decompression in children with traumatic facial paralysis. Methods Eight cases of traumatic facial paralysis that were treated by facial nerve decompression with an external transmastoid-subtemporal labyrinth approach within 1 month between January 2014 and July 2019 were retrospectively analyzed. Some cases underwent ossicular chain reconstruction at the same time. Patients were followed up for 1 to 2 years, and the degree of hearing and facial nerve function(House-Brackmann, H-B)were assessed. Results There were seven cases of H-B grade V and one case of grade Ⅳ preoperatively, which reduced to five cases of grade I and three cases of grade Ⅱ postoperatively; Two cases had severe conductive hearing loss preoperatively, which returned to normal and mild postoperatively; One case had normal hearing preoperatively with no hearing loss postoperatively; The remaining five cases had severe or profound sensorineural hearing loss preoperatively. Conclusions Facial nerve function and hearing can be satisfactorily recovered by facial nerve decompression via an external transmastoid-subtemporal labyrinth approach within 1 month of temporal bone fracture.

Key words: Temporal bone fracture, Facial nerve paralysis, Decompression surgery, Children, Function of facial nerve

中图分类号:

R764

党攀红, 张睿, 胡春燕, 王洁, 樊孟耘. 儿童乳突-颞下迷路外面神经减压术8例临床分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 37-42.

DANG Panhong, ZHANG Rui, HU Chunyan, WANG Jie, FAN Mengyun. Clinical analysis of facial nerve decompression via an external transmastoid-subtemporal labyrinth approach in eight children[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 37-42.

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