Huang Yun-Chen, Wang Shou-Jen, Young Yi-Ho
Department of Otolaryngology, Catholic Cardinal Tien Hospital, Fu-Jen Catholic University, Taipei, Taiwan.
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
Otolaryngol Head Neck Surg. 2015 Jan;152(1):143-8. doi: 10.1177/0194599814557614. Epub 2014 Nov 10.
This study adopted a test battery of cranial nerves (CNs) VII and VIII comprising a facial nerve function test, audiometry, a caloric test, and ocular and cervical vestibular-evoked myogenic potential (oVEMP and cVEMP, respectively) tests to assess the function of CNs VII and VIII comprehensively so as to predict facial nerve recovery in patients with herpes zoster oticus (HZO).
Case series with chart review.
University hospital.
A total of 20 patients with HZO underwent a test battery of CNs VII and VIII. Registering the unaffected nerve bundles in the internal auditory canal was based on the number of normal results in the test battery of CNs VII and VIII. Fair facial nerve recovery is defined as the improvement of facial paresis to facial nerve grades I to II/VI.
In 20 patients with HZO, 6, 7, 3, and 4 patients had 0, 1, 2, and 3 unaffected nerve bundles, respectively. A significantly positive correlation was identified between the number of unaffected nerve bundles and fair facial nerve recovery. Similarly, a statistically significant predictor of fair facial nerve recovery was noted for unaffected nerve bundles (odds ratio, 15.42) but not for grading of the facial nerve (odds ratio, 0.49).
Grading of the facial nerve alone fails to predict the outcome of facial paresis in patients with HZO mainly because it overlooks the involvement of CN VIII. Alternatively, a combined test battery of CNs VII and VIII may serve as a strong predictor for facial nerve recovery.
本研究采用一组由面神经功能测试、听力测定、冷热试验以及眼和颈前庭诱发肌源性电位（分别为oVEMP和cVEMP）测试组成的第VII和第VIII对脑神经（CNs）测试组合，以全面评估CNs VII和VIII的功能，从而预测耳带状疱疹（HZO）患者的面神经恢复情况。
病例系列并进行图表回顾。
大学医院。
共有20例HZO患者接受了CNs VII和VIII的测试组合。根据CNs VII和VIII测试组合中的正常结果数量来记录内耳道中未受影响的神经束。面神经恢复良好定义为面瘫改善至面神经I至II/VI级。
在20例HZO患者中，分别有6、7、3和4例患者有0、1、2和3条未受影响的神经束。未受影响的神经束数量与面神经恢复良好之间存在显著正相关。同样，未受影响的神经束被发现是面神经恢复良好的具有统计学意义的预测指标（优势比，15.42），而面神经分级则不是（优势比，0.49）。
仅面神经分级无法预测HZO患者面瘫的预后，主要是因为它忽略了CN VIII的受累情况。另外，CNs VII和VIII的联合测试组合可作为面神经恢复的有力预测指标。
