Hato Naohito, Fujiwara Takashi, Gyo Kiyofumi, Yanagihara Naoaki
Department of Otolaryngology, Ehime University School of Medicine, Ehime, Japan.
Otol Neurotol. 2014 Oct;35(9):1669-72. doi: 10.1097/MAO.0000000000000468.
The aim of this study was to evaluate the accuracy of the Yanagihara facial nerve grading system in assessing the course of recovery and in determining the probability of a complete recovery of Bell's palsy within 1 week after onset.
Retrospective study of patients at a single trial center.
Tertiary referral center.
Six hundred sixty-four patients with Bell's palsy were assigned to three groups by degree of facial palsy using the Yanagihara 40-point system.
The rate of recovered patients was assessed until 6 months after onset.
Ultimately, 151 (23.1%) patients were assessed with mild palsy, 286 (43.7%) with moderate palsy, and 217 (33.2%) with severe palsy. The average Yanagihara score in the recovered patients was 15.7, whereas the score in the nonrecovered patients was 8.4. The rate of recovered patients in the mild group was 99.3%, that in the moderate group was 95.1%, and that in the severe group was 80.2%. These differences among the groups were significant (p < 0.05).
The Yanagihara system was able to distinguish the probability of a complete recovery of the facial palsy within 1 week after the onset of palsy. We believe that the key point in improving the prognosis of Bell's palsy is to diagnose the severity, using the Yanagihara system, and to treat it promptly to prevent progressive nerve degeneration.
本研究旨在评估柳原面神经分级系统在评估恢复过程以及确定贝尔麻痹发病后1周内完全恢复可能性方面的准确性。
对单一试验中心的患者进行回顾性研究。
三级转诊中心。
664例贝尔麻痹患者使用柳原40分制按面瘫程度分为三组。
评估发病后6个月内的恢复患者比例。
最终，151例（23.1%）患者被评估为轻度麻痹，286例（43.7%）为中度麻痹，217例（33.2%）为重度麻痹。恢复患者的柳原平均评分为15.7，而未恢复患者的评分为8.4。轻度组的恢复患者比例为99.3%，中度组为95.1%，重度组为80.2%。各组间差异有统计学意义（p<0.05）。
柳原系统能够区分面瘫发病后1周内完全恢复的可能性。我们认为，改善贝尔麻痹预后的关键在于使用柳原系统诊断病情严重程度，并及时治疗以防止神经进行性变性。
