闭合性颅脑损伤伴面瘫的手术治疗

Operative Treatment of Facial Palsy due to Closed Craniocerebral Injury

目的 探索颅底骨折伴发面神经损伤的治疗方式。方法分析27例颅底骨折伴发面瘫患者的临床表现、影像学资料、手术方法及随访结果。结果所有患者均接受中颅底硬膜外围膝状神经节面神经管减压术，无手术相关的并发症出现。术后3个月．14例面瘫恢复至House和Brackmann分级Ⅲ级，3例Ⅳ级，2例V级，8例未见恢复；术后6个月复查时15例恢复至Ⅰ～Ⅱ级，4例Ⅲ级，2例Ⅳ级，6例未见恢复。结论中颅底硬膜外围膝状神经节面神经管减压可使大部分外伤性面瘫患者症状改善。

Objective To estimate the operative effect of facial palsy due to temporal bone fracture. Methods Twenty-seven cases of facial palsy due to temporal bone fracture were retrospectively reviewed on the clinical manifestations, imaging data, operative methods and follow-up results. Results All the patients with unilateral complete facial palsy underwent facial nerve canal decompression in the perigeniculate region. No one experienced operationrelated complications. At 3 months follow-up, 14 cases were at Ⅲ scale of House and Brackmann＇ s facial nerve function, 3 cases Ⅳ scale, 2 cases Ⅴ scale and 8 cases had no change. Six months after operation, there were 15 cases at Ⅰ-Ⅱ scale, 4 cases Ⅲ scale, 2 cases Ⅳ scale,and 6 cases had no change. Conclusion Most facial palsy due to temporal bone fracture may be partly or completely recovered with facial nerve canal decompression in the peri- geniculate region.