本文選題：慢性中耳炎　切入點：面神經(jīng)　出處：《中華耳科學雜志》2014年03期

【摘要】：目的研究慢性中耳炎患者手術(shù)中如何保護面神經(jīng)水平段(鼓室段),避免術(shù)后面癱的發(fā)生。方法收集2012年1月至2013年12月在我科住院的慢性中耳炎患者46名,共50耳行手術(shù)治療。術(shù)前均行顳骨CT平掃+三維重建,術(shù)前仔細閱片。手術(shù)方式包括鼓室探查術(shù)、鼓室成形術(shù)、乳突改良根治術(shù)和聽力重建術(shù)。術(shù)前估計面神經(jīng)在水平段和垂直段暴露的幾率,結(jié)合術(shù)中所見,總結(jié)術(shù)中如何保護面神經(jīng)水平段的操作要領(lǐng)。結(jié)果術(shù)中發(fā)現(xiàn)面神經(jīng)水平段暴露13例,乳突段(垂直段)暴露2例,術(shù)后出現(xiàn)短暫面癱1例,出現(xiàn)短期頭暈的患者8例,術(shù)后無永久性面癱患者。結(jié)論在慢性中耳炎手術(shù)中面神經(jīng)有較高的暴露幾率,面神經(jīng)水平段的暴露幾率較其他部分偏高,掌握保護面神經(jīng)的操作要領(lǐng),才能有效的保護面神經(jīng),避免面癱并發(fā)癥。
[Abstract]:Objective to study how to protect the horizontal segment of facial nerve (tympanic segment) in patients with chronic otitis media. Methods 46 cases of chronic otitis media hospitalized in our department from January 2012 to December 2013 were collected. A total of 50 ears were treated with surgery. The temporal bone was reconstructed by CT scan before operation, and the films were carefully read before operation. The operative methods included tympanic exploration, tympanoplasty, tympanoplasty, Modified mastoidectomy and hearing reconstruction. Preoperative estimation of the exposure of facial nerve to horizontal and vertical segments, combined with intraoperative findings, Results 13 cases of horizontal segment of facial nerve, 2 cases of mastoid segment (vertical segment), 1 case of temporary facial paralysis and 8 cases of short-term dizziness were found during the operation, including 13 cases of exposure of horizontal segment of facial nerve, 2 cases of exposure of mastoid segment (vertical segment), and 8 cases of short-term dizziness. Conclusion in the operation of chronic otitis media, the facial nerve is more likely to be exposed, and the exposure rate of the horizontal segment of the facial nerve is higher than that of the other parts, so that the facial nerve can be protected effectively only by mastering the operative key of protecting the facial nerve. Avoid complications of facial paralysis.
【作者單位】： 南方醫(yī)科大學第三附屬醫(yī)院耳鼻咽喉頭頸外科;
【基金】：廣東省自然科學基金,(S2011040005318) 南方醫(yī)科大學第三附屬醫(yī)院院長基金,(A200901)
【分類號】：R764.9

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本文編號：1673760