中耳乳突术后迟发性面瘫

Clinical analysis of delayed facial paralysis after middle ear surgery

目的探讨中耳乳突手术后迟发性面瘫的产生原因、治疗措施及结果。方法回顾2000~2004年发生的4例中耳乳突术后迟发性面瘫病例,均采用保守治疗,并行面神经肌电图检测,面神经功能评估采用HouseBrackmann分级法。结果4例迟发性面瘫均发生于术后5~10天,面瘫程度为Ⅲ~Ⅴ级,采用药物治疗,辅以局部理疗。3例痊愈,面神经功能恢复至Ⅰ级;1例好转,面神经功能恢复至Ⅱ级。结论中耳乳突术后一周左右发生的迟发性面瘫为非神经直接损伤所致,属于神经失用,保守治疗有效。

OBJECTIVE To discuss the causes,managements and results of delayed facial paralysis after middle ear surgery.METHODS 4 cases of delayed facial paralysis after middle ear surgery were reviewed during 2000 to 2004.All 4 cases were managed conservatively,and examined by electromyogram.Facial nerve functions were evaluated according to the HouseBrackmann grading.RESULTS All 4 cases of delayed facial paralysis occurred during 5 to 10 days after middle ear surgery.The facial nerve functions ranged from grade Ⅲ to gradeⅤ.Dexymethason and antivirus drugs were used and physiotherapy was ordered in these cases.Full recovery were seen in 3 cases in which the facial nerve function turned to be grade Ⅰ.One patient was better after therapy whose facial nerve function recovered to be grade Ⅱ.CONCLUSION Facial nerve were not injuried directly in the delayed facial paralysis which occurs in a week after middle ear surgery.Conservative treatment is effective.