Is the Width of the Labyrinthine Portion of the Fallopian Tube Implicated in the Pathophysiology of Bell's Palsy?: A Prospective Clinical Study Using Computed Tomography
Is the Width of the Labyrinthine Portion of the Fallopian Tube Implicated in the Pathophysiology of Bell's Palsy?: A Prospective Clinical Study Using Computed Tomography
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DOI：
10.1002/lary.20896
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发表时间：
2010-06-01
期刊：
影响因子：
2.6
通讯作者：
Danielides, Vasilios
中科院分区：
文献类型：
--
作者：
Kefalidis, Georgios;Riga, Maria;Danielides, Vasilios
目的/假设：贝尔麻痹的发病机制仍然不清楚，尽管广泛的相关研究。磁共振成像（MRI）研究强烈表明，面神经水肿不能被视为唯一的病因，因为它可能会持续很长一段时间后，完全临床恢复，或可能会在临床上未受影响的一侧或健康对照。本研究的目的是调查的假设，一个狭窄的面管可能会牵连在贝尔的palesthes.Study设计：前瞻性临床study.Methods的病理生理学：一个高分辨率的计算机断层扫描的颞骨与1毫米厚的连续轴向部分进行了25例单侧贝尔麻痹。结果：患侧输卵管口孔处的输卵管宽度明显小于健侧，患侧输卵管口孔处的输卵管宽度大于健侧，患侧输卵管口孔处的输卵管宽度大于健侧，差异有统计学意义结论：Bell麻痹多与患者输卵管狭窄有关。这一解剖学细节得到了先前MRI研究的支持，似乎表明左右输卵管之间的不对称可能是在较窄的输卵管中将面神经水肿发展为贝尔麻痹的必要发病机制。在将显著的面神经管不对称与贝尔氏麻痹的高风险联系起来之前，需要对大量健康人群进行更多的研究。
Objectives/Hypothesis: The pathogenetic mechanisms underlying Bell's palsy remain obscure, despite the extensive relevant research. Magnetic resonance imaging (MRI) studies have strongly indicated that facial nerve edema cannot be regarded as the sole etiologic factor, because it might persist long after full clinical recovery, or might be demonstrated in the clinically unaffected side or healthy controls. The aim of this study was to investigate the hypothesis that a narrow facial canal might be implicated in the pathophysiology of Bell's palsy.Study Design: Prospective clinical study.Methods: A high-resolution computerized tomography of the temporal bone with 1-mm thick contiguous axial sections was performed in 25 patients with unilateral Bell's palsy. The width of the fallopian tube was measured at the meatal foramen and the middle part of its labyrinthine segment.Results: When using paired Student t tests, the measured width of the affected ear was found significantly smaller than that of the unaffected side, both at the meatal foramen (P = .007) and at the middle part of the labyrinthine segment (P = .03).Conclusions: Bell's palsy seems to usually coincide with the narrower fallopian tube of the patient. This anatomical detail, supported by previous MRI studies, seems to indicate that an asymmetry between the right and left fallopian tube might be a necessary pathogenetic mechanism for the development of a facial nerve edema into Bell's palsy in the narrower fallopian canal. More studies on large healthy populations are needed before a notable facial canal asymmetry is linked to a higher risk for developing Bell's palsy.