Ikeda Minoru, Nakazato Hidehisa, Onoda Keiko, Hirai Ryoji, Kida Akinori
Department of Otolaryngology, Nihon University School of Medicine, Oyaguchi-kamimachi, Tokyo, Japan.
Acta Otolaryngol. 2006 Jan;126(1):95-100. doi: 10.1080/00016480500265950.
The clinical and surgical findings of this study indicated advanced cholesteatoma in many patients with facial paralysis. The outcome of facial paralysis was good. Poor outcomes were observed in cases with petrosal cholesteatoma and in those who underwent surgery > or = 2 months after the onset of paralysis.
To investigate clinical features of cholesteatoma associated with facial paralysis.
Sixteen patients with facial paralysis due to middle ear cholesteatoma were reviewed. After removal of the cholesteatoma lesion, a limited area of the fallopian canal, that in which facial nerve edema or redness was evident, was opened. Incision of the epineural sheath for nerve decompression was not performed.
Initial paralysis was incomplete in 11 patients (69%). The onset of paralysis was sudden in 12 patients (75%). Labyrinthine fistulae (n = 9; 56%) and bone destruction in the cranial fossa (n = 10; 63%) were frequently observed. Six patients (38%) were totally deaf due to labyrinthitis. The outcome of facial paralysis was good in 13 patients (81%). Patients who underwent surgery > or = 2 months after the onset of paralysis frequently had a poor outcome. Paralysis was not improved in two cases with petrosal cholesteatoma.
本研究的临床和手术结果表明，许多面瘫患者存在晚期胆脂瘤。面瘫的预后良好。岩部胆脂瘤患者以及在面瘫发作后2个月或更长时间接受手术的患者预后较差。
探讨与面瘫相关的胆脂瘤的临床特征。
回顾了16例因中耳胆脂瘤导致面瘫的患者。在切除胆脂瘤病变后，打开面神经管的有限区域，即面神经水肿或发红明显的区域。未进行切开神经外膜鞘进行神经减压。
11例患者（69%）初始面瘫不完全。12例患者（75%）面瘫发作突然。经常观察到迷路瘘（9例；56%）和颅窝骨质破坏（10例；63%）。6例患者（38%）因迷路炎完全失聪。13例患者（81%）面瘫预后良好。在面瘫发作后2个月或更长时间接受手术的患者预后往往较差。2例岩部胆脂瘤患者的面瘫未改善。
