A study of intratemporal facial nerve entrapment palsy. -Its early diagnosis and treatment-

颞内面神经卡压性麻痹的研究。

• 批准号: 05671433
• 负责人: SAITO Haruo
• 金额: $ 1.22万
• 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 (C)
• 财政年份: 1993
• 资助国家: 日本
• 起止时间: 1993 至 1994
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-05671433/
• 关键词: Facial nerve; Facial paralysis; Entrapment palsy; Nerve decompression; Physiological testing; Magnetic stimulation; Antidromic nerve response; 逆行性誘発電位; 神経減荷術; 早期診断; 障害部位診断; 絞扼麻痺; 側頭骨

We have been engaged in researches on tasting and management of facial palsy. Supported by the grants, we performed series of experimental and clinical studies. Using our animal model of ischemic facial palsy, we extended the studies to improve treatments of facial palsy and accurate testing for prognosis of facial palsy.Steroids have been clinically used in initial stage of facial palsy. Its effect is based on only clinical experience. Our histopathological studies of the ischemic facial palsy in guinea pigs showed that interstitial edema decreased greatly after administration of steroid, and that hydrocortisone prevented initial edema of the damaged nerve preventing its entrapment in the narrow facial canal. This was the first histopathological report of its effect and the basis. Our clinical study showed that peroral administration of glycerol was effective in early cases of Bell's palsy and prevented pathologic synkinetic movements after recovery of mimic movement.There are cases with Bell's palsy which need surgical decompression even with the use of steroids and glycerol (hyperosmotic diuretics). 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 and also in clinical cases. Recovery from the palsy was faster and the out-comes were better in the cases chosen and decompressed in early phase of palsy by the antidromically evoked facial nerve response stimulated through Stensen's duct.Magnetic orthodromic intracranial facial nerve stimulation is one of the promising methods to detect early changes of the intratemporal segment of the facial nerve. Our study showed that its use was still not practical mainly because of large diameter of commercially available stimulating coils.

我们一直在从事品尝和管理面瘫的研究。在赠款的支持下，我们进行了一系列的实验和临床研究。利用我们的缺血性面瘫动物模型，我们扩展了研究，以改善面瘫的治疗和准确的检测面瘫的预后。类固醇已被用于临床上的面瘫初期。其效果仅基于临床经验。我们对豚鼠缺血性面瘫的组织病理学研究表明，类固醇给药后，间质水肿大大减少，氢化可的松可防止受损神经的初始水肿，防止其卡压在狭窄的面神经管中。这是第一次有组织病理学报道其作用和依据。我们的临床研究表明，口服甘油对早期贝尔麻痹病例有效，并可防止模仿运动恢复后的病理性联动运动。有些贝尔麻痹病例即使使用类固醇和甘油（高渗利尿剂）也需要手术减压。传统的电生理测试，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麻痹的部位、程度和恢复期，临床上也可应用。经Stensen管刺激面神经逆行反应，在面瘫早期减压，恢复快，效果好，磁顺向颅内面神经刺激是检测面神经颞内段早期变化的有效方法之一。我们的研究表明，它的使用仍然是不实际的，主要是因为大直径的市售刺激线圈。

项目成果

齋藤春雄: "基礎的研究から見た小児の顔面神経麻痺の特徴." 小児耳. 15. 21-24 (1994)

Haruo Saito：“从基础研究的角度看儿童面神经麻痹的特征。” 15. 21-24 (1994)

中谷宏章: "逆行性顔面神経誘発電位-早期予後診断的価値について-" Facial N Res Jpn. 13. 107-110 (1993)

Hiroaki Nakatani：“逆行面神经诱发电位 - 关于其在早期预后中的价值 -”Facial N Res Jpn. 13. 107-110 (1993)

中谷宏章: "顔面神経減荷術の有効性について" Facial N Res Jpn. 14. 215-218 (1994)

Hiroaki Nakatani：“论面部神经减负的有效性”Facial N Res Jpn. 14. 215-218 (1994)

斎藤春雄: "顔面痙攣症---痙攣発作ヒストグラムによる評価---" 耳鼻咽喉科臨床. 87(3月発行予定). (1994)

Haruo Saito：“面部痉挛——使用癫痫直方图进行评估——”耳鼻喉科临床 87（预定于 3 月出版）。

竹田泰三: "実験的虚血性顔面神経麻痺に及ぼすステロイドの効果" Facial N Res Jpn. 13. 185-190 (1993)

Taizo Takeda：“类固醇对实验性缺血性面瘫的影响”Facial N Res Jpn. 13. 185-190 (1993)