面神经减压术中听骨链的处理

目的探讨颞骨外伤骨折性面瘫，面神经减压术中听骨链的处理，对面瘫与听力恢复的手术效果。方法对6例不同类型颞骨骨折引起面瘫者行保留，重建听骨链的面神经减压（面神经隐窝径路4例，颢下窝迷路外径路2例）。结果经随访8个月一6年，面瘫恢复满意3例，良好2例，未恢复1例。6例术后听骨链复位和重建，听力达到10—25dB者3例，26—35dB者2例，另1例呈重度感音神经性聋。结论对于颞骨骨折外伤性面瘫进行面神经减压时保全和重建听骨链，有利恢复听力。及早施行该手术有利面神经和听神经功能的恢复和提高，但操作不慎可发生感音性聋并发症。

Objective To explore the effects of ossicular chain treatment of facial nerve decompression in the patients of the facial paralysis caused by traumatic fracture and the effect of hearing regained. Method Facial nerve decompression was performed on 6 cases of facial paralysis caused by different fracture, including 2 cases of outer approach to infratemporal fossa labyrinth, 4 cases of facial nerve reccssus, 1 case of upper approach to temporam labyrinth. Result The follow - up time were from 8 months to 6 years. It showed that 3 patients expressed high degree of satisfaction with the operation, 2 expressed slightly lower degree of satisfaction, hearing regained fault. Among all the patients 3 patients＇ hearing reached l0 - 25dB ; 2 patients＇ hearing increased to 26 -35dB ; 1 patient showed severe neurosensory deafness syndrome. Conclusion During the operation of facial nerve decompression saving and rebuilding of ossicular chain is conducive to maintaining and improving the function of the hearing. It is imperative to carry out such operation as early as possible to facilitate the recovering and enhance the function of facial nerve.