中文摘要：

目的：探讨外伤后双侧颞骨纵形骨折致双侧周围性面瘫行面神经减压手术的适应症、手术时机及疗效。方法回顾性收集外伤后双侧颞骨骨折致双侧周围性面瘫并至少行一侧面神经探查减压手术患者的临床资料,分析外伤致颞骨骨折后双侧面瘫的原因及特点,对比术前与术后、术侧与对侧面神经功能及听力的恢复情况,评估手术疗效。结果8例患者均为男性,其中5例车祸伤、1例坠落伤、2例头部挤压伤,8例中有5例外伤后有颅脑损伤及昏迷史。所有患者外伤当天或清醒后即发现面瘫,颞骨CT显示双侧纵行骨折,术前双侧面神经功能H-B分级Ⅴ～Ⅵ级；3例听力正常,1例双侧传导性聋,4例有高频感音神经性聋。8例患者共11耳行面神经减压术,传导性聋患者同时行听力重建术。术后随访至面神经功能正常或1年以上,面神经功能均恢复至Ⅰ～Ⅱ级,传导性聋患者听力提高约30dBHL。结论车祸是造成颞骨骨折周围性面瘫的主要原因。面神经减压术能提高外伤后即发性面瘫患者的预后,颞骨骨折引起的传导性聋可同时重建听力。

英文摘要：

Objective The purpose of this rieview is to study management of bilateral facial nerve paralysis in temporal bone fracture. Methods This is a retrospective review of 8 cases of bilateral facial paralysis after bilateral temporal bone frac-ture that were treated with facial nerve decompression on at least one side. High-resolution computed tomography, audiomet-rictests and electromyogram （EMG） were obtained. Evaluation of the facial nerve function according to the House-Brackmann （H-B） grading scale. The decision for surgery was based mainly on the results of afore mentioned evaluations. Timing and the efficacy of surgical intervention were evaluated by pre-vs. post-operative facial nerve function assessments, as well as com-parison between the operation side and the opposite side. Results All the 8 patients were male, aged between 19 and 49 years. Traffic accident was the most commom cause （5/8）. Fracture was longitudinal in all 16 temporal bones, with immediate onset of facial paralysis. Preoperative facial nerve function is between gradesⅤ and Ⅵ, in H-B scale, and with l patient showing bilateral conductive hearing loss, 4 Ratients showing bilateral lugh-frequency sensorineural deafness and 3 Ratients showing normal hearing. Among 8 patients, Facial nerve decompression was performed in 11 ears. H-B gradeⅠ-Ⅱfacial nerve function were aclueved in all cases at follow up （more than l year in some）. The only patient with bilateral conductive hearing loss also received bilateral ossicular reconstruction, followed by recovery to normal hearing. Conclusions Traffic crash continues to be themain cause of temporal bone fracture and hilaterd faial paralysis and hilaterd faial paralysis. Facial paralysis caused by tempo-ral bone trauma can be satisfactorily treated with decompression.