Hammerschlag P E, Cohen N L
Department of Otolaryngology, New York University Medical Center, NY 10016.
Otolaryngol Head Neck Surg. 1990 Nov;103(5 ( Pt 1)):681-4. doi: 10.1177/019459989010300502.
Facial nerve paralysis associated with cerebellopontine angle surgery has been reported to range up to 26% in a recent series. Various methods of intraoperatively monitoring the facial nerve have been developed to reduce the incidence of facial paralysis. We report our experience with an intraoperative monitoring technique using intramuscular EMG electrodes to detect subclinical electrical responses that were amplified and made audible to the operating surgeon after gating stimulus artifacts. A 3.6% incidence of facial paralysis in 111 consecutive cases with this intraoperative monitoring method compared with 14.5% in 207 previously unmonitored cases indicates significant reduction of this complication in cerebellopontine angle surgery (p less than 0.001). Along with this reduction in facial paralysis, an increase in the percentage of partial facial paresis was observed in the monitored group (p less than 0.05). The percentage of those with intact facial function was similar in the monitored (82.0%) and unmonitored groups (78.3%).
据最近的一系列报道，与桥小脑角手术相关的面神经麻痹发生率高达26%。为降低面神经麻痹的发生率，已开发出多种术中监测面神经的方法。我们报告了使用肌内肌电图电极进行术中监测技术的经验，该技术可检测亚临床电反应，在门控刺激伪迹后将其放大并让手术医生听到。采用这种术中监测方法的111例连续病例中，面神经麻痹发生率为3.6%，而之前207例未监测病例中的发生率为14.5%，这表明桥小脑角手术中该并发症显著减少（p<0.001）。随着面神经麻痹的减少，监测组中部分面神经轻瘫的百分比有所增加（p<0.05）。面神经功能完整者的百分比在监测组（82.0%）和未监测组（78.3%）中相似。
