ENTRAPMENT NEUROPATHY IN ACUTE FACIAL PARALYSIS ; CIRCURATORY DISTURBANCE AND ITS TREATMENT

急性面瘫中的卡压性神经病；

• 批准号: 07457402
• 负责人: SAITO Haruo
• 金额: $ 5.31万
• 依托单位: KOCHI MEDICAL SCHOOL
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 1995
• 资助国家: 日本
• 起止时间: 1995 至 1997
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07457402/
• 关键词: Facial palsy; decompression; incomplete recovry; pathologic synkinesis; circulatory disturbance; facial nerve; biofeed back; HRP; マイクロスフェア; 逆行性輸送; 薬物的減荷; 顔面神経; 絞扼麻痺; 麻痺モデル; グリセロール; 神経減荷

There have been scant information on circulation of the facial nerve under compression. Aim of the research was to study histologic evidence of compression of the vessels, and treatment to overcome the compression produced in the temporal bone. A infused resin study showed that vessels were hardly identifiable at the stage of miximum swelling. In normal guinea pigs and after administration of glycerol, vessels were identifiable in peri-and epineurium. There are communicative routes between the CSF and interstitial space of the facial nerve. Microspheres passing study showed that the route closed at initial swelling stage of palsy. After administration of glycerol, the route reopened.The glycerol had effective only 24 hours with single shot mainly in the geniculate ganglion area. Serial administration is necessary. Taking off the canal at the time of nerve damage not only reduced the incidence of palsy, but also severe palsy. In clinical cases, decompression within 7 days of onset of the palsy reduced the cases recovered with pathologic synkinesis. To prevent circulatory disturbance of the nerve, we proposed early total facial nerve decompression ; medically in the labyrinthine and geniculate segment, and surgically in the tympanic and mastoid segment.

关于面神经受压后的循环情况的资料很少。本研究的目的是研究血管压迫的组织学证据，以及克服颞骨压迫的治疗方法。灌注树脂研究表明，在混合肿胀阶段，血管几乎无法识别。在正常豚鼠和甘油给药后，血管可在周围和神经外膜识别。脑脊液与面神经间隙之间存在交通通路。微球通过研究表明，在麻痹的初始肿胀阶段，通路关闭。注射甘油后，通路重新开放，甘油仅在24小时内有效，主要在膝状神经节区单次注射。连续给药是必要的。在神经损伤时拔除椎管不仅减少了麻痹的发生率，而且减少了严重麻痹的发生率。在临床病例中，发病7天内减压可减少病理性联带运动的病例。为了防止神经的循环障碍，我们建议早期全面神经减压术;医学上在胸骨和膝状体段，手术上在鼓室和乳突段。

项目成果

Kishimoto S: "Blood distribution in the facial nerve in temporal bones acquired from cases with subarachnoid hemorrhage" Laryngoscope. (1997)

Kishimoto S：“从蛛网膜下腔出血病例中获得的颞骨面神经的血液分布”喉镜。

竹田 泰三: "虚血生麻痺モデル動物に対する減荷術の効果" Facial N Res Jpn. 16. 187-191 (1996)

Taizo Takeda：“减轻体重对缺血性麻痹模型动物的影响”Facial N Res Jpn. 16. 187-191 (1996)

竹田 節子: "岩様部枝遮断動物の顔面神経麻痺経過" 耳鼻. 42. 1082-1088 (1996)

Setsuko Takeda：“岩支阻断动物的面神经麻痹过程”耳鼻喉科 42. 1082-1​​088 (1996)。

Hamada M :"Effect of glycerol on treatment of peripheral facial palsy : Second report" Facial N Res Jpn.15. 169-172 (1995)

Hamada M：“甘油对周围性面瘫治疗的效果：第二份报告”Facial N Res Jpn.15。

Takeda S :"An animal model of ischemic facial palsy : Histological findings I" Otolaryngology. 43. 38-47 (1997)

武田 S：“缺血性面瘫动物模型：组织学发现 I”耳鼻喉科。