Toplu Yuksel, Kalcioglu Mahmut Tayyar, Karatas Erkan, Bayindir Tuba
From the Department of Otorhinolaryngology, Medical Faculty, Inonu University, Malatya, Turkey.
J Craniofac Surg. 2013 Nov;24(6):e539-41. doi: 10.1097/SCS.0b013e31828601a6.
Facial nerve (FN) macrodehiscence, in contrast to microdehiscence, generally occurs as a result of chronic otitis media and is rarely seen congenitally. A patient with normal hearing who had no history of ear disease or ear operation came to the clinic with recurrent facial paralysis (FP) and frequent blockage of the external ear canal with epithelial debris complaints. In the explorative ear surgery, we observed that the posterior wall of the external ear canal or tympanic ring was absent, a large external ear cavity was covered with a thin skin, the FN was under the skin, and the tympanic-mastoid segment of the FN and chorda tympani extending to the stylomastoid foramen was completely open. FP episodes were associated with the unprotected FN.To prevent an attack of FP, and to self-clean the external ears, mastoid obliteration surgery was performed, and the mastoid segment of the FN was covered with a conchal cartilage graft. This case was diagnosed as congenital aplasia of the external ear canal due to the tympanic bone aplasia-mastoid bone hypoplasia, and the dehiscence of the mastoid-tympanic segment of the FN, and as a cause of recurrent FP, has never to date been identified.
与面神经微裂不同，面神经大裂通常由慢性中耳炎引起，先天性罕见。一名听力正常、无耳部疾病或耳部手术史的患者因反复面瘫（FP）和外耳道频繁被上皮碎屑堵塞前来就诊。在耳探查手术中，我们观察到外耳道后壁或鼓环缺失，大的外耳道腔被薄皮肤覆盖，面神经位于皮下，面神经鼓室-乳突段和延伸至茎乳孔的鼓索完全开放。面瘫发作与面神经无保护有关。为防止面瘫发作并清洁外耳道，进行了乳突封闭手术，面神经乳突段用耳甲软骨移植覆盖。该病例被诊断为由于鼓骨发育不全-乳突骨发育不良导致的先天性外耳道发育不全，以及面神经乳突-鼓室段裂开，作为反复面瘫的原因，迄今为止尚未明确。
