Changes of blood supply after intracanal decompression of the facial nerve

面神经管内减压术后血供变化

• 批准号: 01480407
• 负责人: SAITO Haruo
• 金额: $ 4.16万
• 依托单位: Kochi Medical School
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (B)
• 财政年份: 1989
• 资助国家: 日本
• 起止时间: 1989 至 1991
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-01480407/
• 关键词: Facial paraoysis; Hypertonic diuretics; Ischemic paraoysis; Facial nerve decompression; レ-ザ-ドップラ-; 顔面神経血流; 顔面神経; 微小循環; 麻痺; 神経変性; 初期膨化; 障害部位診断

There has been contravergy about the value of surgical decompression in cases of peripheral facial palsy. We have been engaged in researches on tasting and management 'of facial palsy. Outcomes of the surgical intervention with cases of severe facial palsy is not excellent as expected. Supported by the grant, we performed series of experimental and clinical studies. Our previous studies showed that interstitial fluid pressure of the facial nerve totally depended on CSF pressure, and that the interstitial pressure could be reduced by administration of mannitol.We extended the studies to improve treatments of facial palsy.We made an animal model of ischemic facial palsy by interrupting blood flow of the great petrosal aretery. Lesar doppler monitoring of blood flow of the facial nerve showed that decreased blood flow in ischemic facial palsy recovered after administration of mannitol. Histopathological studies of the ischemic facial nerve in guinea pigs showed that interstitial edema decreased after administration of mannitol. Mannitol prevented nerve degeneration of the nerve. Our clinical study also showed that mannitol was effective 'in early cases of Bell's palsy to prevent synkinesis after recovery of mimic movement.There are cases with Bell's palsy which need surgical decompression even with the use of mannitol decompression method.Conventional electrophysiological testings, such as ENOG, are not effective for selecting surgical cases. The site, degree, and recovering phase of the ischemic palsy could be monitored by antidromic facial nerve response in guinea pigs.The authors stress that accurate testing of the facial nerve lesion with antidromic response and early intracanal decompression of the nerve with mannitol is important to improve therapeutic results of facial palsy.

周围性面神经麻痹手术减压的价值一直存在争议。我们一直在从事研究的品尝和管理的面神经麻痹。严重面神经麻痹的手术治疗效果并不理想。在基金的支持下，我们进行了一系列的实验和临床研究。本实验室以往的研究表明，面神经间质液压力完全依赖于脑脊液压力，而甘露醇可降低面神经间质液压力，因此，本实验通过阻断岩大动脉血流，建立了缺血性面神经麻痹动物模型，观察了缺血性面神经麻痹的发生、发展及治疗效果。Lesar多普勒面神经血流监测显示缺血性面瘫血流减少在甘露醇治疗后恢复。豚鼠缺血面神经的组织学研究表明，甘露醇给药后，间质水肿减轻。Mannesty防止神经变性的神经。我们的临床研究还表明，甘露醇对早期Bell麻痹患者在恢复模仿运动后防止联带运动是有效的。即使使用甘露醇减压法，仍有Bell麻痹患者需要手术减压。传统的电生理检查，如ENOG，对选择手术病例无效。应用豚鼠面神经逆行反应可监测缺血性面瘫的部位、程度和恢复期，作者强调，准确检测面神经逆行反应损伤，早期应用甘露醇行面神经管内减压术，对提高面瘫的治疗效果有重要意义。

项目成果

齋藤 春雄: "末梢性顔面神経麻痺" JOHONS. 5. 49-53 (1989)

Haruo Saito：“周围性面神经麻痹”JOHONS。5. 49-53 (1989)

Saito H: "Non-operative facial nerve decompression Long-Tern Results and Indications Otology and Otoneurosurgery" Kugler and Ghedini Publications, Amsterdam. 287-291 (1991)

Saito H：“非手术性面神经减压长期结果和适应症耳科和耳神经外科”Kugler 和 Ghedini Publications，阿姆斯特丹。

Saito H: "Facial nerve to facial canal crossーsectional area ratio in children" Laryngoscope. 102. (1992)

Saito H：“儿童面神经与面管横截面积之比”喉镜 102。（1992）

Takeda T.;Takeuchi S.;Kishimoto S.;Saito H.: "Interstitial fluid pressure in the facial nerve:Relationship between facial nerve and cerebrospinal fluid pressure." American Journal of Otolaryngology. 10. 345-350 (1989)

Takeda T.；Takeuchi S.；Kishimoto S.；Saito H.：“面神经间质液压力：面神经与脑脊液压力之间的关系。”

Kishimoto S.;Nishiyama S.;Furuta M.;Saito H.: "Communicative route between the interstitial space of the facial nerve and CSF space:a hisatopathological study.In “the facial Nerve"" Kugler & Ghedini Publications,Amstelveen, 59-61 (1990)

Kishimoto S.;Nishiyama S.;Furuta M.;Saito H.：“面神经间质空间和脑脊液空间之间的通讯路径：组织病理学研究。在“面神经”中”Kugler & Ghedini Publications，Amstelveen，59 -61 (1990)