当药物治疗不充分时,面神经麻痹的各种病因,包括贝尔氏麻痹,亨特综合征,和创伤,通常需要手术干预。面神经减压手术旨在缓解神经压迫,恢复功能,保持听力功能,尤其是在儿科病例中,至关重要。常规方法,比如经乳突入路,听骨操纵影响听觉功能的风险。在这里,我们描述了一个12岁男孩的病例,该男孩患有左面神经麻痹,被诊断为带状疱疹(ZSH)综合征。尽管接受了治疗,病人的情况没有好转,提示面神经减压手术。采用完整的经乳突骨(ITO)摇摆技术,我们尽量减少听骨操作,保留听觉功能,同时有效实现面神经减压。患者表现出听觉和面神经功能术后改善。此外,听力测量评估显示听力阈值没有实质性下降,在House-Brackmann量表上,面神经功能从V级改善为II级。与传统方法相比,ITO技术提供了一种侵入性较小的替代方法,降低听骨链的机会和术后听力损失的风险。这个案例突出了定制手术入路在小儿面神经减压手术中的意义,改善患者预后。需要进一步的研究来验证这种方法在各种临床环境中的有效性和安全性。
When pharmacological treatments are inadequate, facial nerve paralysis from various etiologies, including Bell\'s palsy, Hunt syndrome, and trauma, often requires surgical intervention. Facial nerve decompression surgery aims to relieve nerve compression and restore function, with preserving hearing function, especially in pediatric cases, being crucial. Conventional methods, like the transmastoid approach, risk affecting auditory function due to ossicle manipulation. Herein, we describe the
case of a 12-year-old boy with left facial palsy diagnosed with zoster sine herpete (ZSH) syndrome. Despite medical treatment, the patient\'s condition did not improve, prompting facial nerve decompression surgery. Employing the intact transmastoid ossicle (ITO) swaying technique, we minimized ossicular manipulation, preserving auditory function while effectively achieving facial nerve decompression. The patient demonstrated improvement postoperatively in auditory and facial nerve functions. Furthermore, audiometric assessments demonstrated no substantial deterioration in hearing thresholds, and the facial nerve function improved from Grade V to Grade II on the House-Brackmann scale. The ITO technique provides a less invasive alternative compared to conventional approaches, lowering the chance of the ossicular chain and the risk of postoperative hearing loss. This
case highlights the significance of customized surgical approaches in pediatric facial nerve decompression surgery, resulting in improved patient outcomes. Further research is required to validate the efficacy and safety of this method across various clinical contexts.