[Diagnosis and treatment of 68 cases of traumatic facial nerve paralysis].
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi
; 38(5): 405-410, 2024 May.
Article
en Zh
| MEDLINE
| ID: mdl-38686478
ABSTRACT
Objective:
To summarize the clinical characteristics and therapeutic effect of traumatic facial nerve palsy.Methods:
Sixty-eight cases of traumatic facial nerve palsy were retrospectively analyzed from January 2015 to May 2023.Results:
The median course of disease was 33 days. The facial nerve function of the patients was grade HB-â ¡in 2 cases, grade HB-â ¢ in 4 cases, grade HB-â £in 16 cases, grade HB-â ¤ in 37 casesï¼38 earsï¼, and grade HB-â ¥ in 9 cases. 42 cases occurred immediately after injury and 26 cases were delayed. CT examination of temporal bone revealed longitudinal fractures in 51 casesï¼52 earsï¼ , transverse fractures in 6 cases and mixed fractures in 4 cases. No definite temporal bone fracture was found in the remaining 7 cases. The segments of facial nerve injury in 49 casesï¼50 earsï¼ were geniculate ganglion and adjacent, in 7 cases were vertical segment, in 7 cases were horizontal segment, in 2 cases were horizontal segment and vertical segment; and the other 3 cases could not be evaluated. Conservative treatment with glucocorticoids was used in 23 ears and surgery was used in 46 ears. Patients were followed up 6-24 months after treatment, including 20 cases of grade HB-â , 19 cases of grade HB-â ¡, 23 casesï¼24 earsï¼ of grade HB-â ¢, 4 cases of grade HB-â £, and 1 case of grade HB-â ¤.One patient was lost to follow-up. After treatment, the facial nerve function of patients was significantly improvedï¼P<0.05ï¼, and there were significant differences between conservative treatment group and surgical treatment group in the course of facial nerve palsy, the ratio of facial palsy immediately after injury, the nerve function before treatment and the nerve function after treatmentï¼P<0.05ï¼. There were no significant differences in age, sex, hearing condition, temporal bone fracture, facial nerve injury segment and rate of favorable neurologic outcomesï¼P>0.05ï¼. The comparison of patients with neurodegeneration rate>90% and ≤90% showed that the facial nerve function of patients with neurodegeneration rate>90% before treatment was significantly worseï¼P<0.05ï¼, but there was no significant difference between the facial nerve function after treatmentï¼P>0.05ï¼. There was no significant difference in facial nerve function between middle fossa approach group and mastoid approach groupï¼P>0.05ï¼.Conclusion:
Patients with traumatic facial nerve palsy should be evaluated individually. Patients with mild facial nerve palsy, low neurodegeneration rate and short course of disease can be treated conservatively and followed up closely. Patients with severe facial nerve palsy, high neurodegeneration rate and more than 6 weeks of disease can be actively considered surgery. Good prognosis can be obtained by correct evaluation and treatment.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Traumatismos del Nervio Facial
/
Parálisis Facial
Límite:
Adolescent
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Adult
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
Zh
Revista:
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi
Año:
2024
Tipo del documento:
Article