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2017-04-09 发布于江苏
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Surgical management of facial paralysis resulting from temporal bone.pdf

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Surgical management of facial paralysis resulting from temporal bone

Acta Oto-Laryngologica. 2014; 134: 656–660 ORIGINAL ARTICLE Surgical management of facial paralysis resulting from temporal bone fractures YIQINGLIU, JIEHAN, XUANCHENZHOU, KUNGAO, DEHENGLUAN, FENGYANGXIE, XIAOTING WANG, GUANGXIN ZONG LING DING Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial Hospital affiliated to Shandong University, Jinan, China Abstract Conclusion: To achieve good facial reanimation in cases with facial paralysis resulting from temporal bone fractures, the ideal timing for surgical intervention is at least within 1 month of injury and an appropriate surgical approach should be selected depending on the site of facial nerve injury. Objective: This paper aimed to address the ideal time for surgical intervention and the appropriate surgical approach for patients with facial paralysis resulting from temporal bone fractures. Methods: We retrospectively investigated 60 patients with facial paralysis due to temporal bone fractures who underwent facial nerve decompression via different operative approaches within 1 month after trauma, of which 48 were surgically treated by the middle cranial fossa approach (80%), 8 by a pure transmastoid approach (13.3%), and four by a combined transmastoid and middle cranial fossa approach (6.7%). The House–Brackmann (H-B) grading system was used to evaluate the recovery of facial nerve function. Results: The follow-up period for all the patients was 1 year. Among 60 patients who were surgically treated, 39 achieved grade I of facial nerve function, 18 achieved grade II, two achieved grade III, and one achieved grade IV according to the H-B grading system. Keywords: Surgical approach, facial nerve injury, middle cranial fossa approach, transmastoid approach Introduction Traumatic facial nerve paralysis accounts for about one-third of peripheral facial nerve paralysis 80% of which is caused by temporal bone fractures, and the remainder are associated with all kind of iatrogenic injuries, such