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经颞部入路至颅底手术中面神经保护的改进

IMPROVED PRESERVATION OF FACIAL NERVE IN TRANSTEMPORAL APPROACHES TO THE SKULL BASE.

作者信息

Ravikumar A, Gill H S, Bhatoe H S, Singh Prakash, Batish V K

机构信息

Classified Specialist (ENT), Military Hospital, Shillong.

DDMS, HQ 3 Corps, C/o 99 APO, Lucknow-2.

出版信息

Med J Armed Forces India. 2000 Jan;56(1):13-16. doi: 10.1016/S0377-1237(17)30081-3. Epub 2017 Jun 8.

Abstract

Surgery of the skull base has evolved over the past 100 years. The importance of combined otorhinological and neurosurgical approach in the management of lesions of the skull base has been realised in recent years. Through this strategy, lesions which were once thought unresectable are being removed completely with reduction in mortality. However, the morbidity due to facial palsy in lateral skull base surgery is common. To avoid this, intraoperative facial nerve monitoring was introduced in the late 70's and has been refined to such a point that it is now possible to safely predict the recovery of the temporary facial paralysis after lateral skull base surgery. The present study which was carried out in the Armed Forces for the first time has evaluated this by comparing 5 patients who underwent this surgery without intraoperative facial nerve monitoring with 5 patients who were operated with intraoperative facial nerve monitoring. The results have proved the efficacy of this tool in reducing the severity and duration of facial palsy after this surgery.

摘要

颅底外科手术在过去100年中不断发展。近年来,人们已经认识到耳鼻喉科和神经外科联合手术方法在颅底病变治疗中的重要性。通过这种策略,曾经被认为无法切除的病变现在能够被完全切除,同时死亡率也有所降低。然而,在侧颅底手术中,面神经麻痹导致的发病率很常见。为了避免这种情况,术中面神经监测于70年代末被引入,并不断完善,以至于现在可以安全地预测侧颅底手术后暂时性面瘫的恢复情况。本研究首次在军队中进行,通过比较5例未进行术中面神经监测的手术患者和5例进行了术中面神经监测的手术患者来对此进行评估。结果证明了该工具在降低该手术后面神经麻痹的严重程度和持续时间方面的有效性。

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