Clinical characteristics and prognosis of two anastomosis techniques in the treatment of facial nerve defects
Objective:To investigate the characteristics and prognosis of two anastomosis techniques in repai-ring facial nerve defects.Methods:A retrospective analysis was conducted on 30 patients who underwent facial nerve anastomosis(direct or rerouting)for facial nerve defects in our department from January 2012 to December 2021.Among them,21 were male and 9 were female,with an average age of(37.53+11.33)years,all with uni-lateral onset.Preoperative House-Brackmann(H-B)facial nerve function grades were Ⅳ in 2 cases,Ⅴ in 9 cases,and Vlin 19 cases.The duration of facial paralysis before surgery was within 6 months in 21 cases,6-12 months in 6 cases,and over 1 year in 3 cases.The causes of facial paralysis included 14 cases of cholesteatoma,6 cases of fa-cial neurioma,6 cases of trauma,and 4 cases of middle ear surgery injury.Surgical approaches included 9 cases of the middle cranial fossa approach,8 cases of labyrinthine-otic approach,7 cases of mastoid-epitympanum ap-proach,and 6 cases of retroauricular lateral neck approach.Results:All patients were followed up for more than 2 years.The direct anastomosis was performed in 10 cases:6 cases with defects located in the extratemporal seg-ment and 4 cases in the tympanic segment.Rerouting anastomosis was performed in 20 cases:11 cases with de-fects located in the labyrinthine-geniculate ganglion,4 cases from the internal auditory canal to the geniculate gan-glion,3 cases in the internal auditory canal,and 2 cases in the horizontal-pyramid segment.Postoperative H-B fa-cial nerve grades were Ⅱ in 2 cases,Ⅲ in 20 cases,and Ⅳ in 8 cases,with 73.3％(22/30)of patients achieving H-B grade Ⅲ or better.Conclusion:Both direct and rerouting anastomosis techniques can effectively repair facial nerve defects,with no significant difference in efficacy between the two techniques.Most patients can achieve H-B grade Ⅲ or better facial nerve function recovery.Preoperative facial nerve function and duration of facial paraly-sis are the main prognostic factors affecting the outcome of facial nerve anastomosis.
NETL
NSTL
万方数据
