Ramsey Hunt症候群における手術療法の効果

RESULTS OF SURGICAL TREATMENT IN RAMSEY HUNT SYNDROME

　I．緒言

　近年顔面神経外科の進歩は著しいものがあり，その治験例の蓄積は顔神麻痺の治療法に新たな観点をもたらしつつある。特にGlasscock，House ＆ Alford（1970）^1）の"Middle fossa facial nervedecompression"の報告は従来の術式では到達し得なかつた部位への手術を可能とし顔神外科に新局面をもたらした。

　著者らはかつて本症の4症例とともにその文献的検討を行ない，顔神減荷手術時の所見より，いたずらに保存的療法に頼ることは反省する必要もあるのではないかとの問題提起を行なつた^2）。

　The result of surgical treatments in 6 cases of Ramsey Hunt syndrome are reported. Four of these cases were operated upon by transtympanic approach and in 2 cases by that of the middle cranial fossa.

　Facial palsy which followed was recovered completely in 3 cases; almost completely in 1 case and the other 2 cases showed recovery excepting the frontal muscles. In the case affected with dryeye, the facial nerve was found to be engorged and swollen and its most involved portion appeared to bleed easily. This area of the nerve was found to be covering from the pyramidal to the mastoid portions.

　In view of these findings, the authors emphasize that, in cases of marked decrease in lacrimal secretion the entire course of the facial nerve, from the middle cranial fossa through the transtympanic course, should be decompressed.