頭部外傷性顔面神経麻痺—特に局在診断，予後および手術適応について

Facial Palsy Following Head Injury:Topognosis, prognosis and indications for surgical decompression

I．はじめに

　外傷性顔面神経麻痺は，頭部外傷に起因した脳神経麻痺のなかでは発生頻度が高く，比較的しばしばみられる病態である．外傷性顔面神経麻痺は，保存的治療によって大多数の症例では麻痺の回復が期待できるため，手術療法（顔面神経減圧術）を疑問視する傾向^10）がみられる．また手術する場合でも，その手術適応と手術時期についてはいまだ確立した見解はなく，議論の余地のあるところである．

　今同われわれは外傷性顔面神経麻痺患者の25症例について，特に障害部位診断，障害の程度と予後との関係，顔面神経減圧術の手術適応とその成績などにつき検討し，若干の知見が得られたので報告する．

It is a common experience that the facial nerve is affected in closed head injury.

781 patients with head injury were treated at Kobe Central Municipal Hospital over a period of 5 years from January 1977 to April 1982, and facial palsy occurred in 25 cases (3.2%). The male to female ratio was 22:3 and age ranged from 9 to 78 (average 36).

The patients were studied, using radiological, topognostic and electrodiagnostic methods.

Facial nerve decompression was done in 5 cases and 20 cases were treated conservatively.

Results were as follows.

1) The overall rate of complete recovery was 64% (16 of 25 cases).