目的:探讨颞骨外伤骨折性面瘫,面神经减压术中听骨链的处理,对面瘫与听力恢复的手术效果。方法:对6例不同类型颞骨骨折引起面瘫者行保留,重建听骨链的面神经减压(面神经隐窝径路4例,颞下窝迷路外径路2例)。结果:经随访8个月～6年,面瘫恢复满意3例,良好2例,未恢复1例。6例术后听骨链复位和重建,听力达到10～25dB者3例,26～35dB者2例,另1例呈重度感音神经性聋。结论:对于颞骨骨折外伤性面瘫进行面神经减压时保全和重建听骨链,有利恢复听力。及早施行该手术有利面神经和听神经功能的恢复和提高,但操作不慎将发生感音性聋并发症。 Objective: To investigate the surgical treatment of facial paralysis, facial nerve decompression in the treatment of ossicular chain, facial paralysis and hearing recovery. Methods: Facial nerve decompression was performed in 6 patients with facial paralysis caused by different types of temporal bone fractures (4 cases of facial nerve recess pathway and 2 cases of infratemporal fossa lateral approach). Results: After 8 months to 6 years of follow-up, facial paralysis was satisfactorily recovered in 3 cases, good in 2 cases and no recovery in 1 case. Six patients underwent postoperative ossicular chain reduction and reconstruction. Three patients had hearing loss of 10 ~ 25 dB, two patients had 26 ~ 35 dB hearing loss, and the other had severe sensorineural hearing loss. Conclusion: It is helpful to preserve and reconstruct the ossicular chain during decompression of facial nerve with traumatic facial paralysis of temporal bone fracture, which is beneficial to the recovery of hearing. Early implementation of the operation is beneficial facial nerve and auditory nerve function recovery and improvement, but the accidental operation will occur sensory deafness complications.