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CT VIRTUAL ENDOSCOPY IN ASSESSING OSSICULAR CHAIN DISRUPTION CSUSED BY temporal bone fracture AND EAR TRAUMA

Journal of Otology 2013年第2期8卷 104-111页

作者： Jiang Lixin Xiao Zhiwen Department of 0torhinolaryngology Head and Neck Surgery The First Affiliated Hospital of Jinan University 510632

Objective To explore the value of computed tomography virtual endoscopy(VE) in assessing ossicular chain disruption in temporal bone fracture and ear trauma with intact tympanum. Methods High resolution spiral computerized tomography(CT) was completed in 35 cases of temporal bone fracture and 5 cases of tympanum trauma, all with intact or healed tympanum. Three-dimensional reconstruction was completed using a virtual endoscopy software. Audiological tests were conducted in all patients and evaluation of facial nerve injury in patients with facial paralysis. Patients with mild conductive deafness, ossicular chain subluxation on VE, and no facial paralysis were treated conservatively for 4-12 weeks with repeated hearing evaluation; those with facial paralysis underwent surgery if no recovery after 4- 8 weeks of conservative treatment. Patients with moderate to severe conductive hearing loss or mixed hearing loss, incus long process fracture or dislocation on VE and facial paralysis, underwent ossicular chain reconstruction and facial nerve decompression after conservative treatment for 4-8 weeks, or exploratory tympanotomy only if no facial paralysis. VE, audiological tests and facial nerve function tests were repeated in 3-6 months after surgery. Results Of the 6 cases with mild conductive hearing loss, ossicular chain subluxation and no facial paralysis, 3recovered to normal hearing spontaneously and 3 showed no significant improvement, after 4-12 weeks of conservative treatment. After conservative treatment for 4-8 weeks, 3 of the 12 cases with mild conductive deafness, ossicular chain dislocation on VE and facial paralysis recovered to normal hearing and HouseBrackmann(HB) grade I facial function from HB grade II,4 showed facial function recovery to HB grade I(n=2) or II(n=2) from HB grade III but no hearing recovery, and 5 gained no recovery and went on to receive exploratory tympanotomy and facial nerve decompression. The 11 cases with moderate to severe conduct

关键词： temporal bone fracture ear trauma virtual CT endoscopy(VE) computerized tomography(CT) ossicular chain disruption

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Combined Subtemporal-Supralabyrinthine Approach to Geniculate Ganglion for Management of Facial Paralysis in temporal bone fracture

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Journal of Otology 2012年第1期7卷 31-35页

作者： JIANG Li-xin XIAO Zhi-wen MA Yu-kun TU Bo LONG Zhen LIAO Zhi-fang Department of Otolaryngology Head and Neck Surgery The First Affiliated Hospital of Jinan UniversityHuangpu RoadGuangzhouChina.510630.

Objective To investigate the clinical outcomes of facial never decompression via a combined subtemporal-su- pralabyrinthine approach to geniculate ganglion for management of facial paralysis in temporal bone fracture. Methods Eighteen patients with unilateral facial paresis due to temporal bone fracture were treated between March 2003 and March 2011. Facial function was House-Braekmann（HB） grade m in 6 patients, HB grade V in 9 patients and HB grade VI in 3 patients. The preoperative mean air conduction threshold was 52 dB HL for the 15 cases with longitudinal temporal bone fracture and showed severe sensorineural heating loss in the 3 cases with transverse temporal bone fracture. fracture lines were detected in 15 cases on temporal bone axial CT scans and ossicular disruption was determined in 11 cases by virtual CT endoscopy. The geniculate ganglion or the tympanic mastoid segment of the facial nerve showed an irregular morphology on curved planar reformation images of the facial nerve canal. After an intact canal wall mastoi- do-epitympanectomy, the ossicular chain recess was opened by drilling through the was disrupted, the incus was removed to damage was evaluated. If the ossicular chain was intact, the supralabyrinthine cells between the tegmen tympani and ossicular chain. If the ossicular chain access the supralabyrinthine recess. The geniculate ganglion and the distal labyrinthine segment of the facial nerve were exposed. After completing facial nerve decompression, the dislocated incus was replaced, or a fractured incus was reshaped to bridge the space between the malleus and the stapes. Results Pronounced ganglion geniculatum swelling was found in 15 cases of longitudinal temporal bone fracture, with greater petrosus nerves damage in 3 cases and bleeding in 5 cases. Disrupted ossicular chains were seen in 11 cases, including dislocated incus resulting in crushing of the horizontal portion of the facial nerve in 3 cases and fracture of the incus long proce

关键词： temporal bone fracture Facial paralysis Facial nerve decompression Ear surgery

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Surgical Management of Traumatic Facial Paralysis:A Case Review Study

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Journal of Otology 2011年第2期6卷 38-42页

作者： YI Hai-jin1,LIU Pi-Nan2,YANG Shi-ming1 1Department of Otolaryngology,Head and Neck Surgery,Institute of Otolaryngology,Chinese PLA General Hospital,Beijing,China 2Department of neurosurgery division 9 and otolaryngeal-head and neck surgery,Beijing Tiantan Hospital,Capital University of Medical Science,Beijing,China Department of Otolaryngology Head and Neck Surgery Institute of Otolaryngology Chinese PLA General Hospital Beijing China Department of neurosurgery division 9 and otolaryngeal–head and neck surgery Beijing Tiantan HospitalCapital University of Medical Science BeijingChina

Objective To evaluate efficacy of surgical treatment in traumatic facial ***:Thirty-three cases were reviewed,including temporal bone fracture and iatrogenic facial nerve *** the patients were treated with various surgical methods according to their *** The mean percentage facial function improvement (House-Brackmann GradeⅠ-Ⅱ) was 86% in temporal bone fracture and function was improved after proper operation to iatrogenic facial nerve *** Patients with traumatic facial paralysis receive proved outcomes itreaed with proper surgical methods according to their particular condition of nerve injury.

关键词： traumatic facial paralysis temporal bone fracture surgical therapy iatrogenic facial nerve injury

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