García Callejo F J, Velert Vila M M
Acta Otorrinolaringol Esp. 1998 Mar;49(2):173-5.
Peripheral facial palsy is rare after non-otological surgery under general anesthesia. The condition generally is attributed to damage produced by endotracheal intubation maneuvers in patients with anatomic variants of the facial nerve. We report three cases of facial palsy which occurred after abdominal surgery. In every case, nitrous oxide gas was used in anesthesia. One patient had intubation via tracheostomy; all the patients had endocranial facial symptoms and a history of previous surgery. The diversity of these factors suggests that other mechanisms of production aside from damage produced by endotracheal intubation should be considered. The use of nitrous oxide increases middle ear pressure and could produce focal nerve compression. This does not invalidate earlier hypotheses, but does clarify pathophysiological concepts of this condition.
全身麻醉下非耳科手术后发生周围性面瘫较为罕见。这种情况通常归因于面神经解剖变异患者在气管插管操作时产生的损伤。我们报告了3例腹部手术后发生面瘫的病例。每例病例麻醉时均使用了笑气。1例患者经气管切开插管；所有患者均有颅内面神经症状及既往手术史。这些因素的多样性提示，除气管插管造成的损伤外，还应考虑其他产生机制。笑气的使用会增加中耳压力并可能导致局灶性神经受压。这并没有否定先前的假说，但确实阐明了这种情况的病理生理概念。
