경유양동상미로접근법에 의한 안면신경감압술 16례 = 16 Cases of Transmastoid Supralabyrinthine Facial Nerve Decompression

다국어 초록 (Multilingual Abstract)

With increase of traffic accidents, the otologic problems including facial palsy with skull fracture are more concerned. This paper is report our experiences with 16 cases of traumatic facial nerve palsy which have been employed transmastoid supralabyrinthine facial nerve decompression during last four years.
The results are as follows:
1. Of the 16 patients, 13 patients(81.3%) were men and 3 patients (18.8%) were women. And sex ratio was 1.4:1 (male predominent).
2. In fracture type, longitudinal fracture was 10 cases (62.5%), transverse fracture was 1 case(6.3%) and mixed fracture was 2 cases(12.5%).
3. Cerebral contusion was combined in 8 cases(50%) and facial bone fracture was combined in 6 cases(37.55). Because of these combined lesions, otologic diagnoses and treatment was delayed.
4. The most common physical finding on clinical examination were a bloody otorrhea(75%) and hearing impairment(75%).
5. In frequency of lesion in facial nerve, tympanic segment(35.7%) was the most common site, followed by geniculate ganglion(14.3%). Suggested mechanisms in facial palsy were nerve compression(57.1%), granulation tissue and congestion.
6. There were improvment of House-Brackmann grades in 13 cases after decompression.
7. Incudostapedial separation was found in 4 cases and incus fracture was found in 2 cases. Hearing improvement was found in 3 cases being ossiculoplasty.