Résumé
Objective To study the effects of the duration and degree of the peripheral facial paralysis due to middle ear cholesteatoma on the recovery of postoperative nerve functions.Methods The clinical data of 30 cases (single ear) of patients with cholesteatoma complicated with facial paralysis were retrospectively analyzed.The mean age was 54.7±8.9 years old (range 21~77years old) including 17 males and 13 females.The duration of facial paralysis, degree and location of facial nerve injury,surgical timing of facial nerve decompression,recovery of facial paralysis after surgery were followed up.According to the course of paralysis, the patients were divided into ≤2 months group (14 cases) and >2 months group (16 cases).According to the degree of paralysis, the patients were divided into the incomplete facial paralysis group (III-IV grade,14 cases) and the complete facial paralysis group (V-VI grade,16 cases).The influence of the course and degree of paralysis on the postoperative recovery of neurological function were analyzed by the Fisher exact probability test.Results Three cases underwent open radical surgery with no facial nerve damage confirmed by intraoperative exploration, and their postoperative facial nerve functions were fully restored.Facial nerve canal damage was found in 27 cases, accompanied by facial nerve congestion, edema or granulation formation.Among them, the facial nerve damage location was the tympanic segment in 20 cases.The open radical operation and local facial nerve decompression were carried out, and the postoperative facial paralysis recovery rate was 46.67%(14/30).The facial nerve function recovery rate in less than 2 months group was higher than the >2 months group (P<0.05).The facial nerve function recovery rate of the incomplete paralysis group was higher than the complete facial paralysis group (P<0.05).Conclusion This study suggests that facial nerve damage most occurred in the tympanic segment of the facial nerve.Radical mastoidectomy and local facial nerve decompression are effective for the treatment of middle ear cholesteatoma complicated with facial paralysis.The shorter course and lighter degree of paralysis lead to the better postoperative recovery of neurological function.