采用不同治疗方案的双侧同时性创伤性面瘫
Simultaneous bilateral traumatic facial palsy with different treatment protocols.
作者信息
Ardhaoui H, Halily S, Abada R, Rouadi S, Roubal M, Mahtar M
机构信息
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Casablanca University Hospital, Casablanca, Morocco.
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Casablanca University Hospital, Casablanca, Morocco.
出版信息
Int J Surg Case Rep. 2020;74:66-68. doi: 10.1016/j.ijscr.2020.07.073. Epub 2020 Jul 28.
INTRODUCTION
Bilateral simultaneous facial palsy is a rare clinical entity. Traumatic origin is even rarer. Long-term sequelae are disabling. Therefore, rapid and adequate management is crucial.
CASE PRESENTATION
Herein we present a case report of a traumatic bilateral facial palsy in a 43 years old male treated with surgery in one side and conservative treatment in the other side. He achieved eye closure at his 10 months follow up.
DISCUSSION
Electroneurography showing more than 90 % of facial nerve degeneration and electromyography revealing no regeneration potentials are identified as surgical indications. The perigeniculate region is the most commonly injured portion of the facial nerve with temporal bone fractures. Surgical approach to this area remains controversial; transmastoid, middle fossa craniotomy or a combination of both.
CONCLUSION
It is important to discuss expectations with the patient as it might take 12 months to regain maximal nerve function.
引言
双侧同时性面神经麻痹是一种罕见的临床病症。创伤性病因更为罕见。长期后遗症会导致残疾。因此，快速且恰当的治疗至关重要。
病例报告
在此我们报告一例43岁男性创伤性双侧面神经麻痹的病例，一侧接受手术治疗，另一侧接受保守治疗。在10个月的随访中他实现了闭眼功能。
讨论
神经电图显示面神经变性超过90%且肌电图未显示再生电位被确定为手术指征。膝状神经节周围区域是颞骨骨折时面神经最常受伤的部位。该区域的手术入路仍存在争议；经乳突、中颅窝开颅术或两者结合。
结论
与患者讨论预期很重要，因为恢复最大神经功能可能需要12个月。
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