中耳術後面神經斷離以神經移植片修補－病例報告

Facial Nerve Interruption after Middle Ear Surgery Repaired with Nerve Graft - Case Report

廖源長(Yuan-Chang Liao) ； 陳崇宏(Chung-Hung Chen) ； 黃弘孟(Hung-Meng Huang)

《中華民國耳鼻喉科醫學會雜誌》 29卷4期 (1994/08) Pp. 300-304

https://doi.org/10.6286/1994.29.4.300

摘要

面神經麻痺是中耳手術最嚴重的併發症之一，也是耳科醫師最感頭痛的問題；需否施行再手術同時考驗病患與醫師。省立桃園醫院耳鼻喉科經歷一例右側慢性中耳炎合併膽脂的年輕女性病患，施行鼓室成形術和乳突鑿開術手術之後，不幸術後病患發生立即性面神經麻痺。爾後經過連續的神經電圖檢查，結果顯示面神經有逐漸變性現象，於是在第4週再手術。術中發現面神經在水平段有斷離現象，所以取下一段大耳神經，施以神經移植片神經鞘吻合手術。術後追蹤復原情形達8個月，獲致滿意的結果。

關鍵字

面神經麻痺 ； 神經電圖 ； 神經移植片 ； 神經吻合術

並列摘要

Facial nerve palsy is one of the severe complications in middle ear surgery. It tortures both the otologists and patients in deciding to proceed a revised surgery. In this paper, a successful case of facial nerve repair with nerve graft is reported. This female patient received tympanomastoidectomy surgery because of chronic otitis media with cholesteatoma. Immediate facial palsy was noted after surgery. Repeated ENoG examinations in the following days revealed progressive degeneration of the facial nerve. At the revised exploratory operation 4 weeks after the initial operation, the facial nerve was found transsected over the horizontal (tympanic) portion. The gap was repaired with greater auricular nerve graft by epineural neurorrhaphy. She has been followed for 8 months with satisfactory recovery.

並列關鍵字

facial palsy ； EnoG ； nerve graft ； neurorrhaphy