Sun Daniel Q, Andresen Nicholas S, Gantz Bruce J
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N. Caroline St 6th Floor, Baltimore MD, 21287, USA.
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N. Caroline St 6th Floor, Baltimore MD, 21287, USA.
Otolaryngol Clin North Am. 2018 Dec;51(6):1077-1092. doi: 10.1016/j.otc.2018.07.005. Epub 2018 Aug 28.
Bell palsy and traumatic facial nerve injury are two common causes of acute facial palsy. Most patients with Bell palsy recover favorably with medical therapy alone. However, those with complete paralysis (House-Brackmann 6/6), greater than 90% degeneration on electroneurography, and absent electromyography activity may benefit from surgical decompression via a middle cranial fossa (MCF) approach. Patients with acute facial palsy from traumatic temporal bone fracture who meet these same criteria may be candidates for decompression via an MCF or translabyrinthine approach based on hearing status.
贝尔面瘫和外伤性面神经损伤是急性面瘫的两个常见病因。大多数贝尔面瘫患者仅通过药物治疗就能顺利康复。然而，那些完全性面瘫（House-Brackmann 6/6级）、神经电图显示退变超过90%且肌电图无活动的患者，可能从经中颅窝（MCF）入路的手术减压中获益。因颞骨骨折导致急性面瘫且符合这些相同标准的患者，可根据听力状况选择经MCF入路或经迷路入路进行减压。
