听骨链完好者面神经膝节神经节扩大减压术

面神经减压术在面瘫治疗中的价值多持肯定态度。但对听力基本正常，由于面神经连路段远端，膝状神经节及水平段被听骨链遮挡，中耳进路难以彻底显露减压，经颅手术又有颅内并发症的可能。本在应用解剖学研究的基础上，采取经上鼓室前隐窝进路，解决了不损伤听骨链而进行膝状神经节及迷路段远端的减压问题。2例患经该入路手术后，面瘫恢复或好转，听力无改变。

Transtympanic Approach to Total Facial Nerve for the Facial Paralysis with Normal Hearing

The result of the facial nerve decompression for the facial paralysis has been confirmed, but the distal part of the labyrinthine segment, geniculate ganglion and horizontal segment, covered by the auditory ossicles, is hard to be reached through usual transtympanic approach and the decompression through middle cranial fossa approach may be followed by some intracranial complications. Based on anatomical research, the approach of anterior recess of epitympanum was recommended to decompress these segments of the facial nerve to avoid surgical injury to auditory ossicles. Two cases, with this approach, revealed an obvious improvement of the facial paralysis and normal hearing.