面神经电图对爆炸性面神经损伤后的功能及预后评估

Facial electroneurography for evaluating function and prognosis after blast injury of facial nerve

目的:面神经电图是一种客观评价面神经功能的方法,对面神经损伤后的功能测试及评估预后有帮助。观察兔颌面部爆炸伤后面神经的神经电图改变,探讨其临床诊断价值。方法:选用点状爆炸源,距健康雄性新西兰大白兔面部2mm处引爆致伤。分别于伤后于伤后即刻,1,3,7,15,30,60d分别进行面神经电图测定,观察面神经电图的变化。结果:兔颌面部爆炸伤后面神经电图的各项指标都有降低或减弱。伤后即刻,面神经电图各项指标与正常对照组相比差异并无显著性意义;伤后1d,复合动作电位反应波波幅(amplitude,AM)、复合动作电位反应波最大积分面积(squareofmaximum,SM)均有所下降,运动神经传导潜伏(latencytime,LT)、诱发电位持续时间(durationtime,DT)并无显著变化;3d时,面神经电图各项指标均有显著性变化,LT上升,其余指标有所下降;7～15d时各指标较对照组差别达最大;30d时,仅AM,SM指标降低;60d时面神经电图各项指标均大致恢复正常。结论:兔颌面部爆炸伤后面神经电图有明显改变,随损伤后不同时间,各指标有显著差异;兔爆炸性面神经损伤的面神经电图改变模型有一定临床价值,能直观地观察损伤后面神经功能的变化,并有效地评估预后。

AIM:The electroneruography(ENoG) is an objective method to evaluate the function of facial nerve,and it is beneficial for the functional test and prognostic evaluation of the injured facial nerve.The aim of this paper is to observe the change of ENoG of facial nerve in rabbits suffering from maxillofacial blast injury so as to discuss its clinical benefit. METHODS:Punctate explosive source was employed,and the explosive was exploded on the left faces of 20 healthy male New Zealand white rabbits. 0,1,3,7,15,30,and 60 days after injury, the facial nerves of rabbits were detected with ENoG and the changes of ENoG were observed. RESULTS:After the maxillofacial balst injury of rabbits,all indexes of ENoG were decreased or weakened.The very moment after injury,there was no significant difference in the indexes of ENoG between the normal control group and the injured group.After one day injury,amplitude(AM) and square of maximum(SM) were decreased while latency time(LT) and duration time(DT) still had no significant difference. After 3 days,significant difference was found in all indexes of ENoG,the LT was increased, and other indexes were decreased.The differences of all the indexes were reached their highest points after 7 days to 15 days.After 30 days, only the indexes of AM and SM decreased.After 60 days,the indexes of ENoG all came to the normal levels. CONCLUSION:After maxillofacial blast injury of rabbits,there is obvious change in ENoG.And there are significant differences in all indexes along with time.Through the ENoG model of maxillofacial blast injury in rabbits,the changes of facial nerve function after injured can be observed directly and the outcome can be evaluated effectively,and it has its clinical benefit.