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

关于压迫下面神经循环的资料很少。目的是研究血管受压的组织学证据，以及克服颞骨受压的治疗方法。注射树脂研究表明，在最大肿胀阶段，血管几乎无法识别。在正常豚鼠和给药甘油后，可以在神经膜周围和神经外膜中发现血管。脑脊液与面神经间隙间有相通的通路。微球传递研究表明，该通路在麻痹肿胀初期关闭。服用甘油后，路线重新开放。甘油仅有效24小时，单次注射主要在膝状神经节区。串行管理是必要的。神经损伤时脱管不仅可以减少麻痹的发生，而且可以减少严重麻痹的发生。在临床病例中，在麻痹发作后7天内进行减压可减少病理性联动性恢复的病例。为了防止神经循环障碍，我们建议早期全面神经减压；医学上在迷路节和膝曲节，外科上在鼓室和乳突节。

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.