耳畸形手术的面神经防护（519例手术回顾分析）

为总结耳畸形手术中面神经防护的经验，分析了１９８３年８月￣１９９５年７月底５１９例耳各类畸形手术的临床资料。单纯中耳畸形１３０例中，面神经畸形率为６０．８％（７９／１３０），鼓索神经畸形率为５．４％（７／１３０）；外耳道狭窄伴中耳畸形７５例中，面神经畸形率为６０．０％（４５／７５），鼓索神经畸形率为１３．３％（１０／７５）；外耳道骨性闭锁伴中耳畸形３１４例，面神经畸形率为４２．５％（１４２／３１４

Facial nerve protection during surgery for congenital malformation of the external and middle ear (review of 519 cases)]

The prevention of facial nerve injury in otoplasty for ear malformation is important. This paper analysed 519 cases of ear malformation collected during 10 years from 1985 to 1995. The hearing of 428 cases was improved, of which the hearing of 221 cases did recover to available level. A long-term follow-up of 198 cases showed that 152 cases had kept the same hearing level as that immediately after surgery. In 130 cases with single middle ear malformation the malformation rate of facial nerve was 60.8%(79/130), and that for chorda tympani 5.4% (7/130). In 75 cases of middle ear malformation with stricture of external acoustic meatus the malformation rate of facial nerve was 60.0% (45/75), and that for chorda tympani 13.3%(10/75). In 314 cases of middle ear malformation with atresia of external acoustic meatus the malformation rate of facial nerve was 42.5%(142/314), and that for chorda tympani nerve 100.0%(314/314). Two cases(0.4%) were of surgical facial nerve paralysis. For protection of facial nerve, it was important to master the anatomy of temporal bone and have a high-resolution computed tomographic scanning to identify facial nerve. It was also important to use electroneurographic monitoring when necessary.