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

关于面神经在压迫下的循环情况，信息一直很少。该研究的目的是研究血管压迫的组织学证据，以及克服在颞骨产生的压迫的治疗方法。一项注入树脂的研究表明，血管在最大肿胀阶段几乎无法辨认。在正常豚鼠和甘油给药后，可在神经膜周围和外膜识别血管。脑脊液与面神经间质间隙之间有交通通路。微球通过研究表明，在瘫痪的初期肿胀阶段，该通路关闭。注射甘油后，该通路重新开放。甘油仅有效24小时，单次注射主要在膝状神经节区域。连续管理是必要的。在神经损伤时拔除管子，不仅减少了瘫痪的发生率，而且还减少了严重瘫痪的发生率。在临床病例中，在瘫痪发病后7天内减压可减少病理性联动恢复的病例。为了防止神经的循环障碍，我们建议早期全面神经减压术，内科减压术在迷路和膝曲段，外科减压术在鼓室和乳突段。

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.