Wang Lin'e, Zhang Ruxiang, Zhang Daoxing
Department of Otorhinolaryngology, Beijing Friendship Hospital, Capital University of Medical Science, Beijing, 100050, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2012 Aug;26(16):742-3.
To report the way for searching the chorda tympani nerve and the significance for preserving the chorda tympani nerve during canal-wall-down mastoidectomy and tympanoplasty surgery.
Sixty-six cases with chronic suppurative otitis media underwent canal-wall-down mastoidectomy and tympanoplasty surgery. According to the marker of the short crus of incus, the posterior wall of auditory canal was lowered and crista of the chorda tympani nerve was found through tracing the facial nerve contour. The chorda tympani nerve was preserved after clearing the surrounding tissue.
Among the 66 cases, 24 cases had middle ear cholesteatoma, 42 cases had granulation in middle ear. The cholesteatoma and granulation on the surface of the chorda tympani nerve were cleared thoroughly. No neurotmesis or obvious change of taste occurred after operation.
Canal-wall-down mastoidectomy and tympanoplasty surgery preserving chorda tympani nerve integrality may preserve the structure and function of the chorda tympani nerve, reduce the risk of ossicle extrusion above the head of stapes and serve as a frame for transplanting fascia.
报告在开放式乳突根治术及鼓室成形术中寻找鼓索神经的方法及保留鼓索神经的意义。
对66例慢性化脓性中耳炎患者行开放式乳突根治术及鼓室成形术。以砧骨短脚为标志,降低外耳道后壁,沿面神经轮廓追踪找到鼓索神经嵴。清除鼓索神经周围组织后予以保留。
66例中,中耳胆脂瘤24例,中耳肉芽42例。鼓索神经表面的胆脂瘤及肉芽均被彻底清除。术后无神经断裂或味觉明显改变。
开放式乳突根治术及鼓室成形术中保留鼓索神经的完整性可保留鼓索神经的结构和功能,降低镫骨头上方听小骨脱出的风险,并为移植筋膜提供支架。