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[面神经减压术治疗贝尔麻痹和亨特综合征的疗效分析]

[Effect analysis of facial nerve decompression surgery in the treatment of Bell's palsy and Hunt syndrome].

作者信息

Wang Pu, Zhang Wenyang, Wang Yongfeng, Xia Yin

机构信息

Department of Otorhinolaryngology Head and Neck Surgery,Beijing Tiantan Hospital,Capital Medical University,Beijing,100070,China.

Department of Otorhinolaryngology Head and Neck Surgery,First Affiliated Hospital of Xinjiang Medical University Changji Branch.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 May;38(5):391-394. doi: 10.13201/j.issn.2096-7993.2024.05.008.

Abstract

To summarize and analyze the effect of facial nerve decompression surgery for the treatment of Bell's palsy and Hunt syndrome. The clinical data of 65 patients with facial nerve palsy who underwent facial nerve decompression in our center from October 2015 to October 2022 were retrospectively analyzed, including 54 patients with Bell's palsy and 11 patients with Hunter syndrome. The degree of facial paralysis(HB grade) was evaluated before surgery, and ENoG, pure tone audiometry, temporal bone CT and other examinations were completed. All patients had facial palsy with HB grade V or above after conservative treatment for at least 1 month, and ENoG decreased by more than 90%. All patients underwent facial nerve decompression surgery through the transmastoid approach within 3 months after onset of symptoms. The recovery effect of facial nerve function after surgery in patients with Bell's palsy and Hunter syndrome was summarized and analyzed. In addition, 15 cases in group A(operated within 30-60 days after onset) and 50 cases in group B(operated within 61-90 days after onset) were grouped according to the course of the disease(the interval between onset of symptoms and surgery) to explore the effect of surgical timing on postoperative effect. There was no significant difference between the two groups of patients with Chi-square test(=0.54) in 42 patients(77.8%, 42/54) with Bell's palsy and 7 patients(63.6%, 7/11) in patients with Hunter syndrome who recovered to grade Ⅰ-Ⅱ. According to the course of the disease, 10 cases(66.7%, 10/15) in group A recovered to grade Ⅰ-Ⅱ after surgery. In group B, 39 patients(78.0%, 39/50) recovered to grade Ⅰ-Ⅱ after surgery, and there was no statistically significant difference between the two groups by Chi-square test(=0.58). Patients with Bell's palsy and Hunter syndrome can achieve good results after facial nerve decompression within 3 months of onset, and there is no significant difference in the surgical effect between the two types of patients.

摘要

总结分析面神经减压术治疗贝尔面瘫和亨特综合征的效果。回顾性分析2015年10月至2022年10月在我中心接受面神经减压术的65例面神经麻痹患者的临床资料,其中贝尔面瘫54例,亨特综合征11例。术前评估面瘫程度(HB分级),并完成神经电图(ENoG)、纯音听力测定、颞骨CT等检查。所有患者经至少1个月保守治疗后仍有HB分级Ⅴ级及以上面瘫,且ENoG下降超过90%。所有患者在症状发作后3个月内通过经乳突入路行面神经减压术。总结分析贝尔面瘫和亨特综合征患者术后面神经功能的恢复效果。此外,根据病程(症状发作至手术的间隔时间)将A组(症状发作后30 - 60天内手术)的15例和B组(症状发作后61 - 90天内手术)的50例进行分组,探讨手术时机对术后效果的影响。贝尔面瘫患者42例(77.8%,42/54)和亨特综合征患者7例(63.6%,7/11)恢复至Ⅰ - Ⅱ级,两组患者经卡方检验差异无统计学意义(=0.54)。根据病程,A组10例(66.7%,10/15)术后恢复至Ⅰ - Ⅱ级。B组39例(78.0%,39/50)术后恢复至Ⅰ - Ⅱ级,两组经卡方检验差异无统计学意义(=0.58)。贝尔面瘫和亨特综合征患者在症状发作后3个月内行面神经减压术可取得良好效果,两种类型患者的手术效果差异无统计学意义。

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