本文選題：中耳手術(shù) + 鼓索神經(jīng)　； 參考：《聽力學(xué)及言語疾病雜志》2017年04期

【摘要】：目的探討中耳手術(shù)中鼓索神經(jīng)的處理方法及保護鼓索神經(jīng)的可行性和必要性。方法以2013年9月~2016年3月行中耳手術(shù)的155例(155耳)患者為研究對象,男86例,女69例,年齡19~65歲,平均38.23±5.7歲;其中,鼓室成形術(shù)I型24例,上鼓室切開+鼓室成形術(shù)I型6例,上鼓室切開+鼓室成形術(shù)II型22例,完壁式乳突切開+鼓室成形術(shù)23例,開放式乳突切開+鼓室成形術(shù)74例,鐙骨底板鉆孔+活塞人工鐙骨植入術(shù)6例,均記錄手術(shù)中鼓索神經(jīng)顯露和保護的方法,并觀察患者術(shù)后3天和術(shù)后1月時同側(cè)舌的味覺。結(jié)果 155例中,12例術(shù)中未暴露鼓索神經(jīng),126例術(shù)中完整保留之,故鼓索神經(jīng)保存率為89.03%(138/155),鼓索損傷的17例中15例(88.2%,15/17)術(shù)后3天和術(shù)后1月時舌味覺減退;鼓索神經(jīng)保護完整的126例中13例(10.3%,13/126)術(shù)后3天味覺減退,均于術(shù)后1個月內(nèi)自行恢復(fù);1例在術(shù)后16天發(fā)生遲發(fā)性面癱,經(jīng)糖皮質(zhì)激素治療2周后完全恢復(fù)。在鼓索神經(jīng)保護完整與術(shù)中鼓索神經(jīng)斷裂這兩部分病例間術(shù)后3天和術(shù)后1個月時味覺異常發(fā)生率差異均有統(tǒng)計學(xué)意義(χ~2=57.753,P=0.000;χ~2=124.2,P=0.000)。結(jié)論根據(jù)鼓索神經(jīng)的走行位置和顯露方式不同,在中耳手術(shù)中采取個體化的措施保護鼓索神經(jīng)是可行的,可使患者術(shù)后味覺功能保持良好。
[Abstract]:Objective to explore the treatment of chordal tympanic nerve in middle ear operation and the feasibility and necessity of protecting chordal tympanic nerve. Methods from September 2013 to March 2016, 155 patients (86 males and 69 females, aged 1965 years, mean 38.23 鹵5.7 years) underwent middle ear surgery, including 24 cases of tympanoplasty type I and 6 cases of tympanoplasty type I. Tympanoplasty II, tympanoplasty, tymp@@ Methods of exposure and protection of chorda tympani nerve were recorded and taste sensation of ipsilateral tongue was observed 3 days after operation and 1 month after operation. Results among 155 cases, 12 cases were not exposed to chorda tympani nerve during operation, 126 cases were preserved completely during operation, so the preservation rate of tympanic cord nerve was 89.03 / 155%, 15 out of 17 cases of tympanic cord injury were 88.2% 15 / 17) 3 days after operation and 1 month after operation, the taste and tongue of tongue decreased. Of 126 cases with intact protection of the chorda tympani nerve, 13 cases (10.3% 13 / 126) suffered from loss of taste 3 days after operation. All of them recovered spontaneously within one month after operation. One case developed delayed facial paralysis 16 days after operation and recovered completely after 2 weeks of glucocorticoid treatment. There were statistically significant differences in the incidence of abnormal taste between the two groups at 3 days after operation and 1 month after operation (蠂 2: 57.753, P = 0.000; 蠂 ~ 2, 124.2U, P = 0.000), and the difference was significant between the two groups (蠂 ~ 2, P = 57.753, P = 0.000, P = 0.000, P = 0.000, P = 0.000, P = 0.000). Conclusion it is feasible to take individualized measures to protect the chordal tympanic nerve during middle ear operation according to the location and exposure of the chorda tympani nerve, which can keep the taste function of the patients good after operation.
【作者單位】： 南方醫(yī)科大學(xué)珠江醫(yī)院耳鼻咽喉科;佛山市第一人民醫(yī)院耳科;
【分類號】：R764.9

【參考文獻】

相關(guān)期刊論文 前4條

1 鄒團明;謝南屏;郭夢和;舒繁;張宏征;;人工耳蝸植入術(shù)相關(guān)的面神經(jīng)隱窩及后鼓室應(yīng)用解剖研究[J];臨床耳鼻咽喉頭頸外科雜志;2012年10期

2 趙東;郭龍梅;徐平;;中耳炎手術(shù)中面神經(jīng)定位和辨認的臨床研究[J];聽力學(xué)及言語疾病雜志;2012年03期

3 樓志平;陶朵朵;陳兵;;中耳手術(shù)中鼓索神經(jīng)保護及近期味覺功能變化[J];中國耳鼻咽喉頭頸外科;2012年04期

4 胡正清,王正敏;膽脂瘤型中耳炎鼓索神經(jīng)的研究[J];中華耳鼻咽喉科雜志;2001年02期

【共引文獻】

相關(guān)期刊論文 前10條

1 張宏征;蔡潔青;許木清;賴小思;舒繁;鄒團明;;中耳手術(shù)中鼓索神經(jīng)的保護與效果分析[J];聽力學(xué)及言語疾病雜志;2017年04期

2 徐志華;馮益進;徐永田;張抗美;張小青;王新華;葉銳;牛開元;;鼓索神經(jīng)彈壓對重建聽骨鏈穩(wěn)定性的療效觀察[J];中國中西醫(yī)結(jié)合耳鼻咽喉科雜志;2016年06期

3 陸玲;李嘉怡;錢曉云;陳杰;楊燁;俞晨杰;林川耀;麻曉峰;周函;高下;;透明化面神經(jīng)與鼓索神經(jīng)對于提高人工耳蝸植入術(shù)的安全性研究[J];中國耳鼻咽喉顱底外科雜志;2016年03期

4 劉濤;司運輝;;面神經(jīng)減壓術(shù)中鼓索解剖特點分析[J];基層醫(yī)學(xué)論壇;2016年07期

5 崔哲洙;孫珍龍;吳俊;金玉蓮;;中耳膽脂瘤手術(shù)中鼓索神經(jīng)損傷對味覺的影響臨床觀察[J];延邊大學(xué)醫(yī)學(xué)學(xué)報;2015年04期

6 朱燕飛;項敏;戴國平;;56例中耳膽脂瘤患者重建外耳道的乳突根治術(shù)并發(fā)癥的護理[J];中國鄉(xiāng)村醫(yī)藥;2015年13期

7 張帆;何波;阮標(biāo);湯勇;;CT輔助下人工耳蝸植入患兒面神經(jīng)隱窩發(fā)育研究[J];昆明醫(yī)科大學(xué)學(xué)報;2015年02期

8 李知勝;;反斯氏位和斯氏位在先天性耳聾兒童電子耳蝸植入術(shù)投照中的應(yīng)用對比[J];中國婦幼保健;2014年35期

9 黃艷;汪照炎;吳皓;;蝸窗膜進路人工耳蝸植入相關(guān)顳骨解剖學(xué)[J];國際耳鼻咽喉頭頸外科雜志;2014年04期

10 杜歡樂;李棟;尤慧華;;中耳炎手術(shù)損傷鼓索神經(jīng)后味覺的變化與恢復(fù)性觀察研究[J];中華全科醫(yī)學(xué);2014年06期

【二級參考文獻】

相關(guān)期刊論文 前10條

1 何學(xué)斌;馮永;陳登明;梅凌云;賀楚峰;蔡鑫章;;HRCT指導(dǎo)下人工耳蝸植入術(shù)相關(guān)的解剖研究[J];臨床耳鼻咽喉頭頸外科雜志;2011年10期

2 李健東;李娟;汪學(xué)勇;趙亮;劉永亮;;面神經(jīng)減壓術(shù)中鼓索解剖觀察及臨床意義[J];中國臨床解剖學(xué)雜志;2011年01期

3 杜長生;王社軍;王建禎;吳建廣;;面神經(jīng)顳骨內(nèi)段顯微解剖及其臨床意義[J];中國臨床解剖學(xué)雜志;2010年02期

4 張立濤;唐世雄;付波;朱玲英;;鼓室成形術(shù)后遲發(fā)性面癱臨床觀察[J];中國耳鼻咽喉頭頸外科;2008年05期

5 金建華;余汝堂;陳成春;倪麗艷;邵華信;;幼兒人工耳蝸植入面神經(jīng)隱窩的應(yīng)用解剖學(xué)[J];中國臨床解剖學(xué)雜志;2007年02期

6 田昊;張道行;;3歲以下人工耳蝸植入患兒乳突及面隱窩氣房發(fā)育的測量[J];臨床耳鼻咽喉科雜志;2006年10期

7 遲放魯;王t，

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