面神经兴奋性试验和镫骨肌反射对面神经麻痹预后评估分析

Analysis of Nerve Excitability Test and Stapedial Reflex on the Prognosis of Facial Nerve Paralysis

目的 观察面神经兴奋性试验和镫骨肌反射检测对评估面神经麻痹预后的意义。方法 对 5 0例患者检测面神经各支神经阈值 ,用患测减去健侧相对应的各支神经兴奋阈 ,算出阈差。同时检测患者的镫骨肌反射 ,并对两种检测方法进行比较。结果 双侧神经兴奋阈的差值小于 3.5mA组 4 2例中 ,完全恢复者 34例 ,占 81% ,而大于 3.5mA组 8例中 ,仅 2例恢复 ,占 2 5 % ,前者明显高于后者 (P <0 .0 1)。镫骨肌反射阳性组 36例中 ,完全恢复者 32例 ,占 88.9%。镫骨肌反射阴性组 14例中 ,只有 3例恢复 ,占 2 1.4 % ,前者面神经功能恢复率明显高于后者 (P <0 .0 1)。面神经兴奋性试验阈差小于 3.5mA组和镫骨肌反射阳性组比较 ,面神经功能恢复率无明显差异 (P >0 .0 5 ) ,而面神经兴奋性试验阈差大于 3.5mA组和镫骨反射阴性组比较 ,神经功能恢复率亦无不同 (P >0 .0 5 )。结论 双侧面神经兴奋性试验阈差小于 3.5mA或镫骨反射阳性者提示患侧面神经未严重受损 ,预后较好。

Objective To evaluate the clinical application of nerve excitability test and stapedial reflex on the prognosis of facial nerve paralysis. Methods The threshold of excitability of the branches of facial nerves in both sides and stapedial reflex were tested in 50 patients.Results 34 patients out of 42 with differences of nerve excited threshold less than 3.5 mA showed complete recovery (81%),while only 2 patients out of 8 with the differences of nerve excited threshokd more than 3.5 mA showed recovery (25%), 32 patients out of 36 with positive response of stapedial reflex showed recovery (88.9%), but only 3 patients out of 14 recovered (21.4%) in non-response group.Conclusion The difference of nerve excited threshold of both sides less than 3.5 mA and positive response of stapedial refles showed a better prognosis, suggesting no severe injury to facial nerve and both nerve excitability test and stapedial reflex were useful chinical parameters to predict the prognosis of facial paralysis.