面神经吻合术治疗小脑脑桥角区肿瘤术后面瘫

Facial nerve anastomosis for facial paralysis resulting from surgery of cerebellopontine angle tumors

目的探讨小脑脑桥角区肿瘤术后面神经离断患者行面神经吻合术的方法及效果。方法回顾性分析7例小脑脑桥角区肿瘤术后面神经吻合患者的临床资料，采用House—Brackmann（H—B）评分法进行面神经功能评估，采用面神经端一端吻合和面一舌下神经吻合的手术方法。结果7例均随访，随访时间1～48个月，平均23个月，1例随访时间较短，尚无法评估面神经功能，有效5例，无效1例，其中面神经恢复至H—BⅡ级1例，Ⅲ级2例，Ⅳ级2例。结论面神经吻合术是治疗小脑脑桥角区肿瘤术后面瘫的一种有效治疗方法，能改善多数患者的面神经功能。

Objective To evaluate the efficiency and functional improvement of the facial nerve anastomosis for facial paralysis after cerebellontine angle （CPA） tumor surgery. Methods The clinical data of seven patients with facial paralysis after CPA tumors surgery underwent nerve anastomosis were analyzed retrospectively. House - Brackmann （ H - B ） grading was used to evaluate the pre - , post - operative and follow - up status. The end - end anastomosis of facial nerve was performed in one case, and facial - hypoglossal nerve anastomosis in six. Results All patients were followed - up. The mean time of follow - up was 23 months （ranged from 1 to 48 months）. Among seven cases, the facial nerve function was improved in five cases, unchanged in one, and could not be evaluated in one because of short - time follow - up. The postoperative HB grades were I in one case, HI in two and IV in two. Conclusions Facial nerve anatomosis was a useful treatment for facial paralysis after CPA tumors resection and could improve the facial function.