Yanagihara N, Hato N, Murakami S, Honda N
Department of Otolaryngology, Takanoko Hospital, Matsuyama, Japan.
Otolaryngol Head Neck Surg. 2001 Mar;124(3):282-6. doi: 10.1067/mhn.2001.112309.
We sought to assess the efficacy of transmastoid decompression after steroid treatment.
One hundred one adults with Bell palsy having denervation exceeding 95% after steroid treatment were divided into 2 groups. In 58 patients decompression from the labyrinthine segment to the stylomastoid foramen was performed, and the remaining 43 patients were only followed up. Using the Yanagihara score and House Brackmann grading system, the recovery from the palsy was assessed.
There was a statistically significant difference in the final facial score of the 2 groups. Within 60 days after the onset, the chance of better recovery from the palsy was higher in the patients with decompression.
In the era of steroid treatment, we cannot discard the transmastoid decompression of the facial nerve in the treatment of severe Bell palsy with profound denervation, although further effort is needed to obtain definitive evidence to show the benefit of the operation.
我们试图评估类固醇治疗后经乳突减压的疗效。
101例类固醇治疗后失神经超过95%的贝尔面瘫成年患者被分为两组。对58例患者进行了从迷路段到茎乳孔的减压,其余43例患者仅进行随访。使用柳原评分和House Brackmann分级系统评估面瘫的恢复情况。
两组的最终面部评分存在统计学显著差异。发病后60天内,减压患者面瘫恢复较好的几率更高。
在类固醇治疗时代,对于严重且失神经明显的贝尔面瘫患者,虽尚需进一步努力获取确凿证据证明手术益处,但不能放弃对面神经进行经乳突减压治疗。