Kim In Sup, Shin Seung-Ho, Kim Jinna, Lee Won-Sang, Lee Ho-Ki
Department of Otorhinolaryngology, Yonsei University College of Medicine, 612 Eonjuro, Gangnam-gu, Seoul, Korea.
Yonsei Med J. 2007 Dec 31;48(6):963-8. doi: 10.3349/ymj.2007.48.6.963.
To investigate the correlation between gadolinium enhanced magnetic resonance image (MRI) results and surgical findings of facial nerves in Bell's palsy and Ramsay Hunt syndrome.
From 1995 to 2004, MRI was performed on 13 patients with Bell's palsy or Ramsay Hunt syndrome, who were offered with surgical decompression of the facial nerve through the middle cranial fossa approach. Gadolinium enhanced MRI was performed on all patients and the enhancement of the facial nerve was evaluated by radiology specialists. Operative findings including the degree of the facial nerve segment swelling were examined. Furthermore, the time interval from the onset of palsy to surgery was evaluated.
Swelling of facial nerve segments was found in patients with enhanced facial nerves from MRI. The swelling of the facial nerve in the labyrinthine segment in particular was identified in all patients with enhanced labyrinthine segments in MRI. The intraoperative swelling of geniculate ganglion of facial nerve was found in 78% of patients with enhanced facial segment in MRI (p=0.01). The intraoperative swelling of tympanic segment was observed from fourth to ninth weeks after the onset of palsy.
MRI enhancement of facial nerves in Bell's palsy and Ramsay Hunt syndrome is associated with the extent of intratemporal lesions of facial nerves, especially in the labyrinthine segment.
探讨钆增强磁共振成像（MRI）结果与贝尔麻痹和拉姆齐·亨特综合征患者面神经手术所见之间的相关性。
1995年至2004年，对13例贝尔麻痹或拉姆齐·亨特综合征患者进行了MRI检查，这些患者接受了经中颅窝入路面神经减压手术。所有患者均进行了钆增强MRI检查，并由放射科专家评估面神经的强化情况。检查手术所见，包括面神经节段肿胀程度。此外，评估了从麻痹发作到手术的时间间隔。
MRI显示面神经强化的患者出现面神经节段肿胀。特别是在MRI显示迷路段强化的所有患者中均发现了迷路段面神经肿胀。MRI显示面神经节段强化的患者中，78%在术中发现面神经膝状神经节肿胀（p=0.01）。在麻痹发作后第4至9周观察到鼓室段术中肿胀。
贝尔麻痹和拉姆齐·亨特综合征中面神经的MRI强化与颞骨内面神经病变程度相关，尤其是在迷路段。
