décompression du nerf facial
TRANSCRIPT
Place de la décompression chirurgicale du nerf facial dans les
PFP
Paralysie Faciale Périphérique
• Aiguë ou progressive• APC, Intrapétreux,
Extracrânien
• Traumatiques• Tumorales• Infectieuses
Diagnostic
Prise en charge
Médicale
Décompression chirurgicale
Traumatiques
Iatrogènes
Tumorales
Infectieuses
Virales
Late facial nerve decompression surgery
based on MRI
M. Bruzzo, N. Girard, R. Meller, A. Chays, J. MagnanCHU Nord - Marseille - France
IX ’th International Facial Nerve Symposium
San Francisco - July 2001
• 307 patients with acute facial palsy
• 63 complete palsy
• 24 unrecovered palsy
– 1 patient with normal MRI
– 23 patients with MRI enhancement
Surgical population 1990 - 2000
n = 18
• Complete clinically and electrically paralysis with MRI-enhancement of the homolateral facial nerve
• symptoms duration : 2,98 months
• Ramsay-Hunt eruption : 8
MRI Data
0
5
10
15
20
IC LP GG TP MP
Surgery
No surgery
Outcomes
02468
101214
HB I HBII
HBIII
HBIV
HBV
HBVI
Preop
Immediate Postop
6 months Postop
Not operated
Correlations
0
5
10
15
20
IC LP GG TP MP
MRI
Decompression
Inflammation
Outcomes
• Preoperative
– 4 grade IV
– 11 grade V
– 3 grade VI
• Postoperative
– 11 grade II
– 6 grade III
– 1 grade IV