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目的探讨中耳慢性炎症伴周围性面神经麻痹的发病原因。方法回顾性分析41例中耳慢性炎症伴周围性面神经麻痹病例的临床资料。所有病例术中仔细探查面神经骨管情况及病变累及部位。全部病例的病变组织进行病理学检查。结果 4例(10%)面神经骨管完整,在面神经骨管破坏的病例中,病变累及鼓室段面神经33例(89%)。术后病理结果显示:24例(59%)为胆脂瘤,14例(34%)为肉芽,3例(7%)为结核。结论中耳慢性炎症导致周围性面神经麻痹多与胆脂瘤病变有关,面神经鼓室段是最常受累部位。其主要因素是感染沿神经组织的蔓延而不是受压萎缩。面神经骨管破裂并不是感染扩散的必要条件。
Objective To investigate the pathogenesis of chronic middle-ear inflammation with peripheral facial paralysis. Methods The clinical data of 41 cases of middle ear chronic inflammation with peripheral facial paralysis were analyzed retrospectively. All cases of intraoperative exploration of facial nerve bones and lesion involved parts. All cases of diseased tissue pathological examination. Results In 4 cases (10%), the facial nerve was completely formed. In the cases of facial nerve destruction, 33 cases (89%) involved the tympanic facial nerve. Postoperative pathological findings showed that cholesteatoma was found in 24 (59%), granulation in 14 (34%) and tuberculosis in 3 (7%). Conclusion Chronic inflammation of the middle ear leads to more peripheral facial paralysis associated with the lesions of cholesteatoma. The facial nerve tympanic segment is the most frequently involved site. The main factor is the spread of infection along the nerve tissue rather than atrophy. Facial nerve canal rupture is not a necessary condition for the spread of infection.