Department of Neurosurgery, University of North Carolina, 170 Manning Drive, Campus Box 7060, Chapel Hill, NC 27599, USA.
Am J Emerg Med. 2018 Aug;36(8):1522.e1-1522.e3. doi: 10.1016/j.ajem.2018.04.034. Epub 2018 Apr 18.
We present a case report of a 14-year-old boy who was jumping on a trampoline when he struck his right mastoid on a support pole. The following day, he developed a right-sided facial droop and inability to close his right eye. He presented to the emergency department, where CT of his temporal bone was negative and he was started on prednisone. Over the next month, he had spontaneous recovery of his facial nerve (FN) function. In cases of traumatic FN palsy, urgent referral to otolaryngology is needed, even without a fracture of the temporal bone, as edema within the facial nerve could require decompressive surgery. Steroids, while used in this patient, are of questionable benefit in the limited data available. Patient's with traumatic FN palsies should be instructed to use eye lubricant frequently and tape his eye closed at night, as corneal drying could lead to permanent damage. Proper evaluation, management, and referral are needed in cases of traumatic FN palsy to prevent long-term morbidity.
我们报告了 1 例 14 岁男孩在蹦床上跳跃时,右侧乳突撞到支撑柱的病例。次日,他出现右侧面瘫和右眼无法闭合。他到急诊科就诊,头颅颞骨 CT 未见异常,并开始服用泼尼松。在接下来的 1 个月里,他的面神经(FN)功能自行恢复。在创伤性 FN 麻痹的情况下,即使没有颞骨骨折,也需要紧急转耳鼻喉科就诊,因为面神经内的水肿可能需要减压手术。虽然在该患者中使用了类固醇,但在现有有限的数据中,其益处存在疑问。外伤性 FN 麻痹的患者应经常使用眼润滑剂并在夜间将眼睛贴住,因为角膜干燥可能导致永久性损伤。外伤性 FN 麻痹需要进行适当的评估、管理和转介,以防止长期发病。