Aimoni Claudia, Lombardi Loredana, Gastaldo Ernesto, Stacchini Marco, Pastore Antonio
Department of ENT, University of Ferrara Medical School, Ferrara, Italy.
Arch Otolaryngol Head Neck Surg. 2003 Sep;129(9):940-3. doi: 10.1001/archotol.129.9.940.
To assess the value of clinical (House-Brackmann grading) and neurophysiological (conventional electroneurography) monitoring of the facial nerve before and after (at day 10 and day 80) microsurgical parotidectomy in a group of patients with parotid tumors.
From January 7, 1999, to February 27, 2001, 33 patients were evaluated for parotid neoplasms confirmed by cytologic examination: 27 were benign and 6 were malignant epithelial tumors. All patients underwent preoperative electroneurography of the affected side and the normal contralateral side.
Preoperatively, 27 of 33 patients with benign lesions had normal facial nerve function on clinical and neurophysiological evaluation, while 3 of 6 patients with malignant lesions showed compound muscle action potential abnormalities of amplitude and latency, in the absence of facial nerve deficits. At the first postoperative evaluation, 2 of 6 patients with epithelial cancer and 4 of 27 patients with benign tumors had an absence of voluntary activity and compound muscle action potentials after nerve stimulation at the stylomastoid foramen; 1 patient with a malignant lesion and 5 patients with benign tumors had a transient facial palsy with amplitude reduction or latency prolongation of compound muscle action potential. This abnormality persisted in 2 of 27 patients at the second evaluation performed at day 80 after surgery. In 2 of 6 patients with malignant lesions, the day-80 electroneurogram showed a complete absence of nerve conduction.
Electroneurography is a sensitive tool for monitoring clinically silent facial nerve function deficits in the context of preoperative tumor-induced damage and postsurgical early and late follow-up of nerve function.
评估一组腮腺肿瘤患者在显微外科腮腺切除术前（第10天和第80天）和术后进行面神经临床（House-Brackmann分级）和神经生理学（传统神经电图）监测的价值。
从1999年1月7日至2001年2月27日，对33例经细胞学检查确诊为腮腺肿瘤的患者进行评估：27例为良性，6例为恶性上皮性肿瘤。所有患者均接受了患侧和对侧正常侧的术前神经电图检查。
术前，33例良性病变患者中有27例面神经功能在临床和神经生理学评估中正常，而6例恶性病变患者中有3例在无面神经功能缺损的情况下出现复合肌肉动作电位的幅度和潜伏期异常。术后首次评估时，6例上皮癌患者中有2例以及27例良性肿瘤患者中有4例在茎乳孔神经刺激后无自主活动和复合肌肉动作电位；1例恶性病变患者和5例良性肿瘤患者出现短暂性面瘫，复合肌肉动作电位幅度降低或潜伏期延长。在术后第80天进行的第二次评估中，27例患者中有2例这种异常仍然存在。6例恶性病变患者中有2例在第80天的神经电图显示完全无神经传导。
神经电图是一种敏感的工具，可用于监测术前肿瘤引起的损伤以及术后神经功能的早期和晚期随访中临床上无症状的面神经功能缺损。
