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題名 | Facial Nerve Paralysis Due to Chronic Otitis Media=慢性中耳炎引起之顏面神經麻痺 |
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作者 | 吳敏夫; 徐銘燦; 林鴻清; | 書刊名 | 臺灣耳鼻喉頭頸外科雜誌 |
卷期 | 46:5 2011.09-10[民100.09-10] |
頁次 | 頁247-252 |
分類號 | 416.821 |
關鍵詞 | 慢性中耳炎; 結核性中耳炎; 顏面神經麻痺; Chronic otitis media; Tuberculous otitis media; Facial nerve paralysis; |
語文 | 英文(English) |
中文摘要 | 背景:顏面神經麻痺是慢性中耳炎少見的併發症之一。本研究藉由病歷回顧,分析其致病困、症狀表現、治療方法、及其預後。方法:採回溯性病歷研究方式,回顧自1991至2007年間,由本院耳鼻喉科醫師診斷之12例慢性中耳炎引起顏面神經麻痺之病患,針對其症狀、病因、治療及預後進行分析。12例患者皆追蹤1年以上。結果:共12名為患,其中男性5名、女性7名。致病因方面,5例(5/12, 42%)為乳突炎、4例(4/12, 33%)為膽脂瘤、3例(3/12, 25%)為結核性中耳炎所致。經治療後5名乳突炎患者全數恢復正常;膽瘤、結核性中耳炎則各只有1名恢復正常。加總後有7例(5/12, 42%)顏面神經恢復正常,另外5例(5/12, 42%)則仍有House-Brackmann Grade III以上之顏面神經麻痺。結論:本研究以乳突炎引起之顏面神經麻痺治療效果最佳,結核性中耳炎及膽脂瘤引起之顏面神經麻痺則預後較差。此外,延誤治療者,預後也較差。 |
英文摘要 | BACKGROUND: Facial nerve paralysis due to chronic otitis media (COM) is uncommon. We retrospectively analyzed their etiology, characteristics, treatment modalities, and prognosis.METHODS: This retrospective study was conducted in a tertiary referral center, Mackay Memorial Medical Center、Taipei, Taiwan, from 1991 to 2007. Their clinical characteristics, including duration and onset type of facial nerve paralysis, etiologies and associated pathologies, treatment modalities, and prognosis were analyzed. All patients were under regular follow-up for at least one year.RESULTS: Clinical records of 12 patients (5 men and 7 women) with facial nerve paralysis due to chronic otitis media were reviewed. 5 (5/12, 42%) patients were caused by mastoiditis, 4 (4/12, 33%) by middle ear cholesteatoma, and 3 (3/12, 25%) by tuberculous otitis media. 5 (5/5, 100%) patients with mastoiditis, 1 (1/3, 33%) patient with tuberculous otitis mcdia, and 1 (1/4, 25%) patient with middle ear cholesteatoma had complete recovery. Complete recovery was noted in 7 (7/ 12, 58%) patients, while 5 (5/12, 42%) patients got poor prognosis (House-Brackmann Grade III or worse).CONCLUSIONS: Facial nerve paralysis caused by COM with mastoiditis had better complete recovery rate than tuberculous otitis media and middle ear cholesteatoma. Besides, it was found that longer duration of facial nerve paralysis resulted in poorer outcome in our study. |
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