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目的:探讨开放式鼓室成形术中应用面神经监测对面神经保护作用的临床效果。方法:20例慢性化脓性中耳炎患者,在全身麻醉下行开放式鼓室成形术。术中应用神经完整性监护仪进行面神经定位,记录反应电流阀值及同步反应波振幅。结果:7例胆脂瘤型中耳炎患者术中见鼓室段或乳突段面神经部分暴露,其余13例骨管完整。所有病例均成功诱发面神经同步肌电位反应,面神经暴露组电刺激阈值与面神经非暴露组电刺激阈值相比差异有统计学意义(P<0.01)。术后无面瘫发生。结论:开放式鼓室成形术中行面神经监测有助于定位面神经,避免医源性面神经损伤的发生。
Objective: To investigate the clinical effect of facial nerve monitoring on facial nerve in open tympanoplasty. Methods: Twenty patients with chronic suppurative otitis media underwent open tympanoplasty under general anesthesia. Intraoperative nerve integrity monitor facial nerve positioning, recording the reaction current threshold and synchronous wave amplitude. Results: Seven cases of cholesteatoma otitis media showed tympanic or mastoid facial nerve partial exposure in operation, and the remaining 13 cases were complete. In all cases, the facial nerve synchronous muscle potential response was successfully induced. There was a significant difference between the threshold of electrical stimulation in facial nerve exposed group and the threshold of non-exposed facial nerve group (P <0.01). No facial paralysis occurred after surgery. Conclusion: Open tympanoplasty in the facial nerve monitoring helps to locate the facial nerve, to avoid iatrogenic facial nerve injury.