外傷性顔面神経麻痺の経過について--保存的治療及び減荷術施行40例に関して (服部浩教授開講10周年記念論文集)

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Fifty-six patients of traumatic facial palsy were treated in our hospital during an eleven year period from May 1970 to April 1981.The clinical courses of 40 patients were analyzed and compared. Facial nerve decompression was done in 14 patients and 26 were treated conservatively, the other 16 patients were lost to follow-up.From this study, the following results were obtained:1) The rate of complete recovery in traumatic facial palsy was 58% (23/40).2) In the conservative treatment group, all the patients with incomplete paralysis recovered completely. In those with complete paralysis, there was complete recovery if the initial nerve excitability was normal. In those with abnormal nerve excitability, complete recovery was observed if signs of recovery could be elicited within 25 days from the onset of palsy. However, those with signs of recovery only after two months had exceedingly poor recovery.3) In the surgically treated group, there was better recovery than in the conservative group even if the nerve excitability was abnormal. However, those in whom surgery was conducted 2 months after the onset of palsy had poor recovery.4) Therefore, surgery is indicated in the following cases:a) those with no response to NET b) in those with some response to NET but no signs of recovery after one month from onsetThe nerve excitability test is a good guide in determining the necessity for surgical intervention.5) Better results were obtained in children than in adults. Seven out of ten children (70%) completely regained facial movement.
耳鼻咽喉科臨床学会の論文

外傷性顔面神経麻痺の経過について--保存的治療及び減荷術施行40例に関して (服部浩教授開講10周年記念論文集)

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