Feng Shui, Yin Jinshu, Li Jiandong, Song Zhiyao, Zhao Guomin
The 9th Clinical Medical College, Peking University , Beijing.
Acta Otolaryngol. 2014 Sep;134(9):977-81. doi: 10.3109/00016489.2014.927587. Epub 2014 Jun 25.
When patients with recurrent facial paralysis are encountered, otolaryngologists should check for fissured tongue, and question those patients about orofacial edema, minor symptoms, and family history. Histologic evidence is not necessary for the diagnosis of Melkersson-Rosenthal syndrome (MRS), while coronary high-resolution CT (HRCT) reconstruction of temporal bone and food allergen detection may be beneficial. Prophylactic decompression of the facial nerve for patients with appropriate electrophysiological indication may prevent further facial palsy attacks.
The objective of this study was to analyze the clinical features of a group of patients with MRS with major complaints of facial palsy treated at the Department of Otorhinolaryngology, and to comment on MRS from the perspective of otolaryngologists.
A retrospective review of patient database for the last 6 years in the Department of Otorhinolaryngology in Beijing Shijitan Hospital was performed to find patients diagnosed with MRS.
A total of 44 MRS patients were included in this study. The mean age at onset was 14.1 years. A total of 13 (29.5%) patients had family history, 17 (38.6%) revealed broadened fallopian canal on coronary HRCT reconstruction of temporal bone, and 20/23 (87.0%) patients showed positive results in food allergen detection. Thirty-one patients accepted subtotal facial nerve decompression and only one patient had facial palsy recurrence on the same side as the operation.
当遇到复发性面瘫患者时,耳鼻喉科医生应检查是否有沟纹舌,并询问这些患者有关口面部水肿、轻微症状和家族史。梅尔克森-罗森塔尔综合征(MRS)的诊断不需要组织学证据,而颞骨冠状位高分辨率CT(HRCT)重建和食物过敏原检测可能有益。对于有适当电生理指征的患者,对面神经进行预防性减压可预防进一步的面瘫发作。
本研究的目的是分析一组以面瘫为主诉在耳鼻喉科接受治疗的MRS患者的临床特征,并从耳鼻喉科医生的角度对MRS进行评论。
对北京世纪坛医院耳鼻喉科过去6年的患者数据库进行回顾性研究,以找出诊断为MRS的患者。
本研究共纳入44例MRS患者。发病的平均年龄为14.1岁。共有13例(29.5%)患者有家族史,17例(38.6%)在颞骨冠状位HRCT重建中显示面神经管增宽,23例中有20例(87.0%)患者食物过敏原检测呈阳性。31例患者接受了面神经次全减压,只有1例患者在手术同侧出现面瘫复发。