面神经减压术中听骨链的处理

Pressure-Reduction Operation of Facial Nerve to Save and Rebuild Ear Bone Chains

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,颞下窝迷路外径路2例)。结果:经随访8个月～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,但操作不慎将发生感音性聋并发症。

Objective： This paper explores the effects of Through Pressure-Reduction Operation of facial nerve to save and rebuild the ear bone on the facial paralysis caused by traumatic fracture of temporam bone and on the regaining of hearing.Method： Pressure-reduction operations were conducted on 6 cases of facial paralysis caused by different fracture of temporam bone, including two cases of outer approach to infratem- poral fossa labyrinth, four cases of facial nerve recessus, 1 case of upper approach to temporam labyrinth. Result：The follow-up visit over the period of between 8 months and 6 year after the treatment shows that3 patients expressed high degree of satisfaction with the operation, 2 ex- pressed slightly lower degree of satisfaction, one didn＇t recover his/her hearing. Among all the patients after the operation whose ear bone link was reset and rebuilt, 3 patients＂ hearing reached 10-25riB; 2 patients＂ hearing increased to 26-35dB; 1 patient showed severe neurosensory ~eafness syndrome .Conclusion： During the operation of Trough Prcssure-Beduction of facial nerve on facial paralysis caused by temporam bone traumatic fracture, saving and rebuilding of hearing bone 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 and audio nerve; however, operating mlstakes may lead to enurosensorv deafness syndrome.