摘要
ObjectiveToinvestigatetheclinicaloutcomesoffacialneverdecompressionviaacombinedsubtemporal-supralabyrinthineapproachtogeniculateganglionformanagementoffacialparalysisintemporalbonefracture.MethodsEighteenpatientswithunilateralfacialparesisduetotemporalbonefractureweretreatedbetweenMarch2003andMarch2011.FacialfunctionwasHouse-Brackmann(HB)gradeⅢin6patients,HBgradeⅤin9patientsandHBgradeⅥin3patients.Thepreoperativemeanairconductionthresholdwas52dBHLforthe15caseswithlongitudinaltemporalbonefractureandshowedseveresensorineuralhearinglossinthe3caseswithtransversetemporalbonefracture.Fracturelinesweredetectedin15casesontemporalboneaxialCTscansandossiculardisruptionwasdeterminedin11casesbyvirtualCTendoscopy.Thegeniculateganglionorthetympanicmastoidsegmentofthefacialnerveshowedanirregularmorphologyoncurvedplanarreformationimagesofthefacialnervecanal.Afteranintactcanalwallmastoido-epitympanectomy,theossicularchaindamagewasevaluated.Iftheossicularchainwasintact,thesupralabyrinthinerecesswasopenedbydrillingthroughthecellsbetweenthetegmentympaniandossicularchain.Iftheossicularchainwasdisrupted,theincuswasremovedtoaccessthesupralabyrinthinerecess.Thegeniculateganglionandthedistallabyrinthinesegmentofthefacialnervewereexposed.Aftercompletingfacialnervedecompression,thedislocatedincuswasreplaced,orafracturedincuswasreshapedtobridgethespacebetweenthemalleusandthestapes.ResultsPronouncedgangliongeniculatumswellingwasfoundin15casesoflongitudinaltemporalbonefracture,withgreaterpetrosusnervesdamagein3casesandbleedingin5cases.Disruptedossicularchainswereseenin11cases,includingdislocatedincusresultingincrushingofthehorizontalportionofthefacialnervein3casesandfractureoftheincuslongprocessin1case.In3casesoftransversefractures,
出版日期
2012年01月11日（中国期刊网平台首次上网日期，不代表论文的发表时间）
