gms | German Medical Science

83. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

16.05. - 20.05.2012, Mainz

The surgical management and prognosis of iatrogenic peripheral facial nerve injury after middle ear surgery

Meeting Abstract

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  • corresponding author Weiju Han - 301 Hospital, PLA, Beijing, P.R. China
  • Weidong Shen - 301 Hospital, PLA, Beijing, P.R. China
  • Shiming Yang - 301 Hospital, PLA, Beijing, P.R. China
  • Pu Dai - 301 Hospital, PLA, Beijing, P.R. China
  • Jun Liu - 301 Hospital, PLA, Beijing, P.R. China
  • Dongyi Han - 301 Hospital, PLA, Beijing, P.R. China

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 83. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Mainz, 16.-20.05.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12hnod414

doi: 10.3205/12hnod414, urn:nbn:de:0183-12hnod4148

Veröffentlicht: 4. April 2012

© 2012 Han et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: To discuss the causes, sites and curative effects of accidental facial nerve paralysis in the middle ear surgery. Method Forty two cases with facial nerve paralysis after middle ear surgery were analyzed. The facial nerve function was assessed according to House- Brackmann (HB) Grade.

Results:

1.
The most common operation complicating iatrogenic facial nerve injury is mastoidectomy, and the common sites of facial nerve injury include the tympanic and pyramid segment.
2.
The facial nerve exploration showed facial nerve edema in 9 cases (21.4%), injured of facial nerve sheath in 10 cases(23.8%), partial nerve fibers transection in 4 cases(9.5%), total nerve fibers transection in 17 cases(40.5%) and facial nerve anatomical integrity in 2 case (4.8%).
3.
Facial nerve re-animation methods include facial nerve decompression in 24 cases(57.1%), end-to-end anastomosis in 2 cases(4.8%), end-to-end anastomosis after nerv transfer in 2 cases(4.8%), interpositional nerve grafts with the great auricular nerve in 10 cases (23.8%) and facial- hypoglossal nerve anastomosis in 4 cases (9.5%).
4.
Twenty eight patients were followed up more than 1 year. Of 17 cases who received facial nerve decompression, 4 cases recovered to HB Grade I, 11 cases recovered to HB Grade II, 2 cases recovered to HB Grade III. Of 5 cases who underwent the great auricular nerve grafting, 3 cases recovered to HB Grade II, 2 cases recovered to HB Grade III. Of 4 cases who received facial - hypoglossal nerve anastomosis recovered to HB Grade III. Of 2 cases who underwent the the end-to-end anastomosis recovered to HB Grade II.Conclusion The tmpanic segment as well as pyramid segment are more prone to injury during mastoid surgery. The injured facial nerve should be explored and repaired.