Chung Ji Hyun, Lee Sun Kyu, Kim Sang Hoon, Yeo Seung Geun, Park Moon Suh, Byun Jae Yong
Audiol Neurootol. 2015;20(2):117-121. doi: 10.1159/000369609. Epub 2015 Mar 4.
To investigate the relationship with prognosis, various neurotological examinations evaluating all four nerves within the internal auditory canal were performed in patients with Bell's palsy.
A total of 69 consecutive patients with Bell's palsy were included. They were treated uniformly with steroid and an antiviral agent and underwent neurotological examinations consisting of electronystagmography, pure-tone audiometry (PTA), electroneurography (ENoG), caloric test, rotatory chair test and cervical vestibular evoked myogenic potentials (cVEMP). According to the final recovery state, patients were divided into two groups: a complete recovery group and an incomplete recovery group. The incidence of abnormal findings in each test was compared between the two groups.
Fifty-six patients recovered completely and 13 patients recovered incompletely. No association was observed between the rate of ipsilesional PTA threshold and the rate of abnormal caloric test, function tests and recovery state. However, the initial state of facial palsy, ENoG and the rate of abnormal cVEMP were significantly correlated with the rate of recovery.
The results indicate that Bell's palsy may be more comparable to mononeuritis multiplex and that cVEMP could be a useful tool for predicting the prognosis of Bell's palsy.
为了研究预后关系,对贝尔面瘫患者进行了评估内耳道内所有四条神经的各种神经耳科学检查。
共纳入69例连续的贝尔面瘫患者。他们均接受类固醇和抗病毒药物治疗,并进行了包括眼震电图、纯音听力测定(PTA)、神经电图(ENoG)、冷热试验、转椅试验和颈前庭诱发肌源性电位(cVEMP)在内的神经耳科学检查。根据最终恢复状态,将患者分为两组:完全恢复组和不完全恢复组。比较两组各项检查中异常结果的发生率。
56例患者完全恢复,13例患者不完全恢复。患侧PTA阈值率与冷热试验异常率、功能试验及恢复状态之间未观察到相关性。然而,面瘫的初始状态、ENoG及cVEMP异常率与恢复率显著相关。
结果表明,贝尔面瘫可能与多灶性单神经炎更具可比性,且cVEMP可能是预测贝尔面瘫预后的有用工具。