颅脑外伤伴颞骨骨折合并周围性面瘫15例

Clinical analysis of the facial nerve paralysis after the temporal bone fracture with the craniocerebral trauma

目的探讨严重颅脑外伤患者的面瘫治疗时机、手术方法及治疗效果。方法回顾性分析2004年12月至2008年2月在我院治疗的颅脑外伤伴颞骨骨折合并周围性面瘫的病例15例，均经神经外科治疗后至我科进一步治疗周围性面瘫，进行术前评估、术中对照及术后随访的对比。结果进行全面专科检查并综合患者全身情况，选择合适术式行面神经减压，术后随访2个月～4年，面神经功能恢复至Ⅰ级2例，Ⅱ级11例，Ⅲ级2例。结论对于颅脑外伤伴颞骨骨折合并周围性面瘫的患者，颅脑外伤急诊处理且生命体征平稳后，全面术前评估，积极进行面神经手术减压仍不失为积极有效的治疗措施。

Objective To disscuse the management of facial nerve paralysis after the temporal bone fracture with the craniocerebral trauma. Methods The study design was a retrospective review of fifteen patients who underwent facial nerve paralysis after the temporal bone fracture with the craniocerebral trauma. They all received the treatment of the neurosurgery. Results The follow up period was ranging from 2 months to 4 years. Two patients showed Ⅰ score of House - Brackmann recovery of facial nerve function in follow -up, eleven patients showed Ⅱ score and the last 2 showed Ⅲ score. Conclusions For the patients who underwent facial nerve paralysis after the temporal bone fracture with the craniocerebral trauma, late facial nerve decompression may have still beneficial effects.