Haginomori Shin-Ichi, Wada Shin-Ichi, Ichihara Takahiro, Terada Tetsuya, Kawata Ryo
Department of Otolaryngology - Head & Neck Surgery, Osaka Medical College, Takatsuki, Japan.
Clinical Examination Department, Kagawa Prefectural University of Health Science, Takamatsu, Japan.
Auris Nasus Larynx. 2017 Oct;44(5):602-606. doi: 10.1016/j.anl.2017.01.002. Epub 2017 Jan 22.
Marginal mandibular nerve paralysis is the most frequent complication of benign parotid tumor surgery and results in cosmetic deformity. The purpose of this study was to develop a new electroneurography method for marginal mandibular nerve paralysis using electroneurography (ENoG) and judge its usefulness for clinical practice.
Twenty-seven patients who underwent surgery for benign parotid tumor were enrolled. We proposed and use the mandibular angle method, in which the recording electrode was placed on the skin above the depressor anguli oris muscle while the reference electrode was placed on the skin of the parietal region, and percutaneous electrical stimulation was applied to enclose the mandibular angle that could measure the function of the marginal mandibular nerve solely. Preoperative and postoperative ENoG values were compared in paralytic and non-paralytic patients.
The mean postoperative ENoG value (35.0%) was lower than the preoperative value (90.5%) in paralytic patients, whereas no difference was observed between preoperative (79.3%) and postoperative (69.5%) ENoG values in non-paralytic patients.
A new ENoG method (mandibular angle method) was thought to reflect marginal mandibular nerve injury and might be useful for determining the likelihood of paralysis.
下颌缘支神经麻痹是腮腺良性肿瘤手术最常见的并发症，会导致面部畸形。本研究旨在开发一种新的用于评估下颌缘支神经麻痹的神经电图方法，即使用神经电图（ENoG），并判断其在临床实践中的实用性。
纳入27例接受腮腺良性肿瘤手术的患者。我们提出并采用下颌角法，即将记录电极置于降口角肌上方的皮肤上，参考电极置于顶区皮肤上，并进行经皮电刺激以环绕下颌角，该方法可单独测量下颌缘支神经的功能。对麻痹患者和非麻痹患者术前和术后的ENoG值进行比较。
麻痹患者术后ENoG值的平均值（35.0%）低于术前值（90.5%），而非麻痹患者术前（79.3%）和术后（69.5%）的ENoG值无差异。
一种新的ENoG方法（下颌角法）被认为能够反映下颌缘支神经损伤，可能有助于确定麻痹的可能性。
