慢性中耳炎手术中面神经水平段的保护

发布时间：2018-03-27 23:29

本文选题：慢性中耳炎　切入点：面神经　出处：《中华耳科学杂志》2014年03期

【摘要】：目的研究慢性中耳炎患者手术中如何保护面神经水平段(鼓室段),避免术后面瘫的发生。方法收集2012年1月至2013年12月在我科住院的慢性中耳炎患者46名,共50耳行手术治疗。术前均行颞骨CT平扫+三维重建,术前仔细阅片。手术方式包括鼓室探查术、鼓室成形术、乳突改良根治术和听力重建术。术前估计面神经在水平段和垂直段暴露的几率,结合术中所见,总结术中如何保护面神经水平段的操作要领。结果术中发现面神经水平段暴露13例,乳突段(垂直段)暴露2例,术后出现短暂面瘫1例,出现短期头晕的患者8例,术后无永久性面瘫患者。结论在慢性中耳炎手术中面神经有较高的暴露几率,面神经水平段的暴露几率较其他部分偏高,掌握保护面神经的操作要领,才能有效的保护面神经,避免面瘫并发症。
[Abstract]:Objective to study how to protect the horizontal segment of facial nerve (tympanic segment) in patients with chronic otitis media. Methods 46 cases of chronic otitis media hospitalized in our department from January 2012 to December 2013 were collected. A total of 50 ears were treated with surgery. The temporal bone was reconstructed by CT scan before operation, and the films were carefully read before operation. The operative methods included tympanic exploration, tympanoplasty, tympanoplasty, Modified mastoidectomy and hearing reconstruction. Preoperative estimation of the exposure of facial nerve to horizontal and vertical segments, combined with intraoperative findings, Results 13 cases of horizontal segment of facial nerve, 2 cases of mastoid segment (vertical segment), 1 case of temporary facial paralysis and 8 cases of short-term dizziness were found during the operation, including 13 cases of exposure of horizontal segment of facial nerve, 2 cases of exposure of mastoid segment (vertical segment), and 8 cases of short-term dizziness. Conclusion in the operation of chronic otitis media, the facial nerve is more likely to be exposed, and the exposure rate of the horizontal segment of the facial nerve is higher than that of the other parts, so that the facial nerve can be protected effectively only by mastering the operative key of protecting the facial nerve. Avoid complications of facial paralysis.
【作者单位】：南方医科大学第三附属医院耳鼻咽喉头颈外科;
【基金】：广东省自然科学基金,(S2011040005318) 南方医科大学第三附属医院院长基金,(A200901)
【分类号】：R764.9

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