鼓室乳突手术后迟发性面瘫：15例报告
Delayed facial palsy after tympanomastoid surgery: A report of 15 cases.
作者信息
Xu Peng, Liu Weiwei, Zuo Wenna, Wang Daowen, Wang Hongqin
机构信息
Department of Otolaryngology, Cangzhou Central Hospital, Cangzhou, Hebei Province, People's Republic of China.
Department of Otolaryngology Head and Neck Surgery, Peking University Health Science Center, Beijing, People's Republic of China.
出版信息
Am J Otolaryngol. 2015 Nov-Dec;36(6):805-7. doi: 10.1016/j.amjoto.2015.07.004. Epub 2015 Jul 9.
OBJECTIVE
To analyze potential etiology and outcomes of delayed facial palsy (DFP) after tympanomastoid surgery.
METHODS
Fifteen cases of DFP out of 1582 cases after tympanomastoid surgery were reviewed, and the potential causes and outcomes were analyzed.
RESULTS
9 out of 15 patients (60%) had fallopian canal dehiscence and facial nerve exposure in contrast to 323 of 1567 patients (20.6%) without DFP, with significant difference (P<0.01). Chorda tympani was cut or overstretched in 4 cases. There were two cases with herpes labialis and IgM antibody against varicella-zoster virus. All patients fully recovered within two months.
CONCLUSION
Fallopian canal dehiscence and facial nerve exposure was a risk factor of DFP after tympanomastoid surgery, and chorda tympani injury and viral reactivation may be triggering factors of DFP. The outcomes DFP after tympanomastoid surgery were excellent.
目的
分析鼓室乳突手术后迟发性面瘫（DFP）的潜在病因及预后。
方法
回顾1582例鼓室乳突手术后发生DFP的15例患者，分析其潜在病因及预后。
结果
15例患者中有9例（60%）存在面神经管裂缺及面神经暴露，而1567例无DFP的患者中有323例（20.6%）存在，差异有统计学意义（P<0.01）。4例患者的鼓索神经被切断或过度牵拉。2例患者出现唇疱疹及抗水痘-带状疱疹病毒IgM抗体。所有患者均在两个月内完全恢复。
结论
面神经管裂缺及面神经暴露是鼓室乳突手术后DFP的危险因素，鼓索神经损伤及病毒再激活可能是DFP的触发因素。鼓室乳突手术后DFP的预后良好。
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