創傷性顳骨段面神經麻痺－三例報告

Traumatic Intratemporal Facial Nerve Paralysis - Report of Three Cases

熊明旺(Ming-Wang Hsiung) ； 梁家光(Giia-Guang Liang) ； 林烱堃(Giueng-Kuen Lien) ； 蘇文勇(Wen-Yang Su)

《中華民國耳鼻喉科醫學會雜誌》 32卷2期 (1997/04) Pp. 205-210

https://doi.org/10.6286/1997.32.2.205

摘要

三軍總醫院耳鼻喉部自1994年12月至1995年2月間，以手術處理3名創傷性顳骨段面神經麻痺患者，1名是因橫向顳骨骨折所導致，1名是由縱向顳骨骨折所造成，另1名是因為中耳手術所致。前二名以經乳突探查並施以面神經減壓術，第1名病變位置於膝神經節；第二名於鼓室段。第三名手術是以改良式乳突廓清術並加以面神經縫合術，其病變位置主要是在鼓室段，三名經歷1年的追蹤面神經麻痺有明顯的改善。目前對於創傷性顳骨段面神經麻痺處理之最佳方法及時機仍有爭議，本篇主要討論受傷之機轉及處理之方法與時機供各位參考。

關鍵字

創傷性 ； 顳骨段 ； 面神經麻痺

並列摘要

A retrospective review of 3 cases of intratemporal facial nerve paralysis includes 2 temporal bone fractures and 1 iatrogenic complication. Surgical explo-ration confirmed the involvement of fallo-pian canal in the perigeniculate region in the 1 longitudinal and 1 transverse frac-tures of the petrous pyramid. Iatrogenic injury occurred within the vertical segment of the facial nerve. These cases of intratemporal improved much after one year’s follow up. However, the most appropriate manage-ment of traumatic intratemporal facial nerve paralysis remained a topic of debate. Controversies persisted in regard to the management of immediate or delayed facial nerve paralysis, the selection of an appropriate surgical approach to the injured nerve, and the timing of surgical intervention. We reviewed several suthors’ experiences of traumatic intratemporal facial nerve injury and proposed a ratio-nale of management.

並列關鍵字

traumatic ； intratemporal ； facial nerve paralysis