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背景:常规镫骨手术后仍偶有迟发性面瘫发生,发病机制尚不明确。目的:探讨镫骨手术后迟发性面瘫的发病率、发病机制及治疗。设计:以诊断为依据非对照研究。地点和对象:在南京大学医学院附属鼓楼医院耳鼻喉科完成,对象为该院镫骨手术后迟发性面瘫患者3例,均为女性,年龄34～48岁。方法:回顾性分析该院332例镫骨手术后发生迟发性面瘫的3例患者。主要观察指标:House-Brackmann分度。结果:3例镫骨手术后迟发性面瘫的发病时间在术后5,6d,为不完全性周围性面瘫,检测1例迟发性面瘫患者抗单纯疱疹病毒抗体,呈阳性。以大剂量激素、抗病毒药、维生素治疗为主,并配合针灸治疗,3例患者全部恢复正常。结论:常规镫骨手术后出现迟发性面瘫,除面神经骨管裂隙外,还可能与隐匿的单纯疱疹病毒激活有关。
Background: There is still occasional delayed facial paralysis after conventional tarsus surgery, the pathogenesis of which remains unclear. Objective: To investigate the incidence, pathogenesis and treatment of delayed facial paralysis after tarsal surgery. Design: Diagnostic based non-controlled study. Location and Subject: Completed at Department of Otorhinolaryngology, Drum Tower Hospital affiliated to Nanjing University Medical College, there were 3 patients with delayed facial paralysis after tarsal surgery in the hospital, all female and 34 to 48 years old. Methods: A retrospective analysis of 332 cases of the hospital delayed stapes surgery occurred in 3 patients with delayed facial paralysis. MAIN OUTCOME MEASURES: House-Brackmann indexing. Results: The onset time of delayed facial paralysis in 3 cases of tarsal operation was 5,6 days after operation, which was incomplete peripheral facial paralysis. One case of anti-herpes simplex virus antibody was detected in patients with delayed facial paralysis and was positive. High-dose hormones, antiviral drugs, vitamin therapy-based, and with acupuncture treatment, all 3 patients returned to normal. CONCLUSION: Delayed facial paralysis occurs after conventional tarsal surgery. In addition to facial nerve canal fissures, it may be related to the occult herpes simplex virus activation.