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Intratemporal Grafting of the Facial Nerve following Lateral Skull Base Tumor Resection

机译:颅底外侧肿瘤切除术后面神经的颞内移植

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摘要

Intratemporal skull base tumors may invade the facial nerve in the horizontal (tympanic) or descending (vertical) segments, while parotid malignancies typically infiltrate the facial nerve at the stylomastoid foramen. This article will describe our results following intratemporal facial nerve grafting in 44 patients. Methods: This was a retrospective analysis of 44 patients requiring intratemporal facial nerve repair following lateral skull base tumor resection at our tertiary care, academic medical center. Results: Tumor histology included 17 parotid cancers, 13 temporal bone malignancies, 9 glomus tumors, 3 facial neuromas, and 2 endolymphatic sac tumors. The greater auricular nerve was used in 25 patients and the sural nerve was used in 19 cases. Forty patients were available for facial function assessment at 2 years. Using the House-Brackmann (H-B) recovery scale, the breakdown of patients by facial function was as follows: Grade I, 0 patients; Grade II, 4 patients; Grade III, 29 patients; Grade IV, 4 patients; Grade V, 3 patients; and Grade VI, 0 patients. Conclusions: Facial paralysis may occur from intrinsic or external lateral skull base invasion of the facial nerve. Intratemporal interposition grafting resulted in favorable facial function (H-B II or III) in 33 of the 40 (82.5%) patients at the 2-year assessment.
机译:颞上颅底肿瘤可能会在水平(鼓膜)或下降(垂直)段侵入面神经,而腮腺恶性肿瘤通常会在胸锁乳突孔中渗入面神经。本文将描述44例颞内侧面部神经移植术后的结果。方法:这是一项回顾性分析,分析了我们学术医疗中心三级颅骨基部肿瘤切除术后需要进行颞内面神经修复的44例患者。结果:肿瘤组织学包括17例腮腺癌,13例颞骨恶性肿瘤,9例肾小球肿瘤,3例面部神经瘤和2例内淋巴囊肿瘤。耳大神经25例,腓肠神经19例。 2岁时有40名患者可用于面部功能评估。使用House-Brackmann(H-B)恢复量表,按面部功能分类的患者分类如下:I级,0例; I级,0例; II级,4例; III级,29例; IV级,4例; V级,3例; VI级,0例。结论:面神经的内在或外在颅骨外侧侵犯可能引起面瘫。在两年评估中,40例(82.5%)患者中有33例在颞间插片移植中获得了良好的面部功能(H-B II或III)。

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