摘要： 目的：研究利用颞骨鼓部骨面引导显露面神经主干这一方法的临床可行性。方法：我们在2011-05—2017-05期间，共收治了41例单侧腮腺浅叶良性肿瘤患者，手术均采用顺行面神经解剖方法行部分腮腺浅叶切除术，其中25例利用颞骨鼓部骨面引导的方法显露面神经主干(颞骨鼓部组)，16例利用二腹肌后腹标志显露面神经主干（二腹肌后腹组）。比较2组显露面神经主干的成功率和所用的时间、术后面瘫的发生率。采用SPSS 19.0软件包对数据进行统计学处理。结果：2组的所有病例均顺利显露面神经主干。在显露面神经主干所需时间方面，颞骨鼓部组的平均时间是（16.05±3.28） min，二腹肌后腹组的平均时间是（19.81±3.72） min，差异存在统计学意义（P=0.002）。在术后面瘫的发生率上，颞骨鼓部组25例患者中有9例发生面瘫（36.0%），二腹肌后腹组16例中有7例发生面瘫（43.8%），两组患者均为暂时性面瘫，且面瘫发生率的组间差异，没有统计学意义（P=0.620）。结论：利用颞骨鼓部骨面引导显露面神经主干，是一种安全、可靠和快捷的临床解剖路径。

关键词: 颞骨鼓部, 面神经主干, 二腹肌后腹

Abstract: Objective: The aim of this study was to research the feasibility of using the tympanic part of the temporal bone as a guide for exposure of the facial nerve trunk. Methods: 41 patients with benign tumors of unilateral parotid gland, who underwent partial superficial parotidectomy by anterograde dissection of the facial nerve between May 2011 and May 2017, were included in this study. The operation of 25 patients were guided by the tympanic part of the temporal bone(tympanic part group). The operation of other 16 patients were guided by the posterior digastric muscle(posterior digastric muscle group). The difference of success rate , the time needed for exposure of the facial nerve trunk and the injury to the facial nerve after surgery between the two groups, were noted and compared. All results were statistically analyzed with SPSS 19.0 software package. Results: The facial nerve trunk was exposed successfully in all cases of two groups. There was a significant difference between two groups (P=0.002) in the time needed for exposure of the facial nerve trunk. The average time of tympanic part group was (16.05±3.28) min while that of posterior digastric muscle group was (16.05±3.28) min. There was no significant difference between two groups (P=0.620) in facial nerve injuries after surgery. 9 patients(36.0%) manifested a temporary paralysis in the tympanic part group, and there were7 patients (43.8%) suffered that in the posterior digastric muscle group. Conclusion: The tympanic part of the temporal bone can be used as a guide for exposure of the facial nerve trunk, which is very safe, reliable and quick.

Key words: tympanic part, facial nerve trunk, posterior digastric muscle

中图分类号: 

• R782.7