本文選題：醫(yī)源性面癱 + 中耳手術(shù)　； 參考：《中華耳科學雜志》2014年03期

【摘要】：目的報道中耳手術(shù)中醫(yī)源性面癱的處理經(jīng)驗,并探討醫(yī)源性面癱的原因、臨床特點、處理方式及預防措施。材料與方法回顧分析1995-2014年45例中耳手術(shù)中發(fā)生醫(yī)源性面癱患者的臨床資料,45例患者均接受再次手術(shù)探查,分析術(shù)中探查發(fā)現(xiàn)、面神經(jīng)損傷的部位,程度,治療選擇及預后情況。45例患者中41例來自外院轉(zhuǎn)診。結(jié)果45例醫(yī)源性面癱中,44例為術(shù)中或術(shù)后即刻發(fā)生。術(shù)中探查發(fā)現(xiàn),18例面神經(jīng)損傷位于面神經(jīng)水平段后部,約占40%,最為常見。根據(jù)神經(jīng)損傷程度,23例選擇單純面神經(jīng)減壓術(shù),11例選擇切除神經(jīng)纖維瘤樣組織,離斷部分行端端吻合,其余11例行神經(jīng)間位移植。44例患者術(shù)后隨訪超過1年,32例患者面神經(jīng)功能恢復至HB分級Ⅲ級以內(nèi)。結(jié)論醫(yī)源性面癱是中耳手術(shù)的嚴重并發(fā)癥之一,多于術(shù)中或術(shù)后即刻發(fā)生,盡早手術(shù)探查,并予以正確處理,可以獲得較好的面神經(jīng)功能恢復。
[Abstract]:Objective to report the experience in the management of iatrogenic facial paralysis in middle ear surgery, and to explore the causes, clinical features, treatment and preventive measures of iatrogenic facial paralysis.Materials and methods the clinical data of 45 patients with iatrogenic facial paralysis during middle ear operation from 1995 to 2014 were retrospectively analyzed.Treatment selection and prognosis. 41 of 45 patients were referred from outside hospital.Results among 45 cases of iatrogenic facial paralysis, 44 cases occurred immediately during or after operation.During intraoperative exploration, 18 cases of facial nerve injury were found to be located in the posterior part of the horizontal segment of the facial nerve, accounting for about 40%, the most common.According to the degree of nerve injury, 11 cases of facial nerve decompression and 11 cases of neurofibromatous tissue were resected and end-to-end anastomosis was performed.The other 11 patients were followed up for more than one year. The facial nerve function of 32 patients recovered to HB grade 鈪，

本文編號：1753981