Katedra i Klinika Neurochirurgii, Warszawski Uniwersytet Medyczny, ul. Banacha 1 A, Warszawa.
Neurol Neurochir Pol. 2011 Sep-Oct;45(5):480-8. doi: 10.1016/s0028-3843(14)60317-0.
Facial nerve (CN VII) palsy or even its transient paresis causes physical disability but is also a psychosocial problem. Immediately after vestibular schwannoma removal, different degrees of CN VII paresis occur in 20-70% of patients. Facial nerve paresis is observed in 10-40% after surgery of cerebellopontine angle meningiomas. Postoperative facial nerve weakness significantly reduces or completely withdraws with time in the majority of cases. However, even if prognosis for CN VII regeneration is good, proper management is needed because of the potential for serious ophthalmic complications. In this paper, the authors raise the issue of perioperative prophylaxis and comprehensive treatment of postoperative paresis of CN VII. Prophylaxis and treatment of ophthalmic complications are discussed. Current trends in the treatment of intraoperative loss of facial nerve continuity, management of facial paresis with good prognosis and dealing with facial palsy with no spontaneous recovery are also described in the paper.
面神经（CN VII）麻痹甚至暂时性瘫痪会导致身体残疾，也是一个社会心理问题。在听神经瘤切除术后，20-70%的患者会出现不同程度的 CN VII 瘫痪。桥小脑角脑膜瘤手术后，10-40%的患者会出现面神经瘫痪。大多数情况下，面神经无力会随着时间的推移而逐渐减轻或完全消失。然而，即使 CN VII 再生的预后良好，也需要进行适当的管理，因为存在严重眼部并发症的风险。本文作者提出了围手术期预防和综合治疗 CN VII 术后瘫痪的问题。讨论了预防和治疗眼部并发症的问题。本文还描述了术中面神经连续性中断的治疗趋势、预后良好的面神经瘫痪的处理以及无自发恢复的面瘫的处理。
