摘要
目的:探讨中耳乳突术中面神经裸露发生率、部位及相关因素。方法:对经乳突手术的315耳(胆脂瘤中耳炎217耳,慢性化脓性中耳炎98耳)的临床资料进行回顾性分析,分析面神经裸露发生率及部位,并选择性别、年龄、手术史、术前面瘫、术前并发症、病理类型、外半规管裂、脑膜暴露、乙状窦暴露等9项临床因素进行单因素及多因素Logistic回归分析。结果:315耳中面神经裸露共72耳,总发生率为22.9%,最常见发生部位是鼓室段(93.1%)。单因素分析显示,与面神经裸露相关的因素有术前面瘫、术前并发症、病理类型、半规管裂、脑膜暴露;多因素分析显示,与面神经裸露相关的因素有术前面瘫、病理类型为胆脂瘤、外半规管裂。结论:在乳突根治术中面神经裸露率可高达22.9%,最常见发生部位是鼓室段,术中应小心避免损伤。术前面瘫、病例类型为胆脂瘤、外半规管裂是存在面神经裸露的危险因素,可用于初步估计乳突手术中面神经裸露发生风险的高低。
Objective：To study the incidence and locations of facial nerve dehiscence（FND） in mastoidectomy for the patients with cholesteatoma and chronic otitis media, and to determine its relevance as pre-operative prediction. Method：Three hundred and fifteen ears（217 ears with cholesteatoma and 98 with chronic otitis media） undergoing mastoidectomy with or without tympanoplasties were selected for retrospective study, in which the incidence and locations of FND was studied, and the relevance for FND were analyzed by univariate test following by multivariate stepwise logistic regression. Result： The presence of FND was 22.9% of total surgical procedures and the locations of FND were 93.1% in the tympanic segment, which was significantly higher than in the mastoid segment. The factors as otogenic facial paralysis, pathologic style （cholesteatoma or chronic otitis media） and lateral semicircular canal （LSC） fistula were related to FND, while others factors as sex, age, revision operations, pre- operative complications, dural exposure, sigmoid sinus exposure were not risk factors for FND. Conclusion： The incidence of FND was 22.9% in this study, the most common location for FND was in the tympanic segment, therefore, the facial nerves should be especially taken care in mastoidectomy for patients with presences of otogenic facial paralysis, cholesteatoma and LSC fistula.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2009年第7期289-292,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
胆脂瘤
慢性中耳炎
乳突根治术
面神经
因素分析
cholesteatoma
chronie otitis media
mastoidectomy
facial nerves
factor analysis
