经颅面神经桥接并植入移植体治疗面神经损伤的临床分析

[Clinical analysis of transcranial facial nerve bridging with interpositional graft for the treatment of facial nerve injury].

作者信息

Zhang Weixun, Gao Zheng, Ma Mengye, Lv Jihan, Jia Xianhao, Zhao Weidong, Yuan Yasheng

机构信息

ENT Institute and Department of Otorhinolaryngology,Eye & ENT Hospital,Fudan University,Shanghai,200031,China.

Lateral Skull Base Diagnosis and Treatment Center,Eye Ear Nose and Throat Hospital,Fudan University.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 May;38(5):376-379. doi: 10.13201/j.issn.2096-7993.2024.05.005.

Abstract

To retrospectively analyze the effectiveness of transcranial facial nerve bridging in the treatment of facial nerve dysfunction. A retrospective analysis was conducted on 27 patients with facial nerve dysfunction who underwent transcranial facial nerve bridging at the Eye, Ear, Nose, and Throat Hospital affiliated with Fudan University from 2017 to 2022. The main collected data includes the patient's age, gender, primary lesion, damaged location, interval from facial paralysis to surgery, and preoperative and postoperative House-Brackmann(HB) scale for facial nerve function. Statistical comparisons were made between the average HB level of patients before and after surgery. A total of 27 patients included 17 males and 10 females. The average age of patients during surgery is(42.50±3.38) years old. Primary lateral skull base diseases include trauma(=3), tumors(=22), and infections(=2). The duration of facial paralysis varies from 6 months to 5 years. Statistics analysis has found that the average postoperative HB score of patients who underwent transcranial facial nerve bridging was significantly lower at(3.750 ± 0.183) compared to preoperative(4.875±0.168). The proportion of patients with good facial nerve function increased significantly from 7.4% before surgery to 42.9% after surgery. Transcranial facial nerve bridging surgery with interpositional graft has a significant effect on improving facial nerve function in patients with facial nerve injury. Further research is still needed to evaluate the long-term effectiveness of this surgery, to determine the optimal patient selection criteria and postoperative rehabilitation strategies.

摘要

回顾性分析经颅面神经桥接术治疗面神经功能障碍的有效性。对2017年至2022年在复旦大学附属眼耳鼻喉科医院接受经颅面神经桥接术的27例面神经功能障碍患者进行回顾性分析。主要收集的数据包括患者的年龄、性别、原发病变、损伤部位、面瘫至手术的间隔时间以及术前和术后面神经功能的House-Brackmann(HB)量表。对患者手术前后的平均HB水平进行统计学比较。27例患者中男性17例,女性10例。患者手术时的平均年龄为(42.50±3.38)岁。原发性侧颅底疾病包括外伤(3例)、肿瘤(22例)和感染(2例)。面瘫持续时间为6个月至5年。统计分析发现,接受经颅面神经桥接术的患者术后平均HB评分为(3.750±0.183),显著低于术前(4.875±0.168)。面神经功能良好的患者比例从术前的7.4%显著增加到术后的42.9%。带植入物的经颅面神经桥接术对改善面神经损伤患者的面神经功能有显著效果。仍需进一步研究以评估该手术的长期有效性,确定最佳的患者选择标准和术后康复策略。

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