中耳手术医源性面瘫的处理

发布时间：2018-04-15 11:34

  本文选题：医源性面瘫 + 中耳手术　； 参考：《中华耳科学杂志》2014年03期

【摘要】：目的报道中耳手术中医源性面瘫的处理经验,并探讨医源性面瘫的原因、临床特点、处理方式及预防措施。材料与方法回顾分析1995-2014年45例中耳手术中发生医源性面瘫患者的临床资料,45例患者均接受再次手术探查,分析术中探查发现、面神经损伤的部位,程度,治疗选择及预后情况。45例患者中41例来自外院转诊。结果45例医源性面瘫中,44例为术中或术后即刻发生。术中探查发现,18例面神经损伤位于面神经水平段后部,约占40%,最为常见。根据神经损伤程度,23例选择单纯面神经减压术,11例选择切除神经纤维瘤样组织,离断部分行端端吻合,其余11例行神经间位移植。44例患者术后随访超过1年,32例患者面神经功能恢复至HB分级Ⅲ级以内。结论医源性面瘫是中耳手术的严重并发症之一,多于术中或术后即刻发生,尽早手术探查,并予以正确处理,可以获得较好的面神经功能恢复。
[Abstract]:Objective to report the experience in the management of iatrogenic facial paralysis in middle ear surgery, and to explore the causes, clinical features, treatment and preventive measures of iatrogenic facial paralysis.Materials and methods the clinical data of 45 patients with iatrogenic facial paralysis during middle ear operation from 1995 to 2014 were retrospectively analyzed.Treatment selection and prognosis. 41 of 45 patients were referred from outside hospital.Results among 45 cases of iatrogenic facial paralysis, 44 cases occurred immediately during or after operation.During intraoperative exploration, 18 cases of facial nerve injury were found to be located in the posterior part of the horizontal segment of the facial nerve, accounting for about 40%, the most common.According to the degree of nerve injury, 11 cases of facial nerve decompression and 11 cases of neurofibromatous tissue were resected and end-to-end anastomosis was performed.The other 11 patients were followed up for more than one year. The facial nerve function of 32 patients recovered to HB grade 鈪，

本文编号：1753981