Azuma Takahiro, Nakamura Katsuhiko, Takahashi Mika, Miyoshi Hitomi, Toda Naoki, Iwasaki Hidetaka, Takeda Noriaki
Department of Otolaryngology, University of Tokushima School of Medicine, Tokushima 770-8503, Japan.
Department of Otolaryngology, University of Tokushima School of Medicine, Tokushima 770-8503, Japan.
Auris Nasus Larynx. 2018 Aug;45(4):728-731. doi: 10.1016/j.anl.2017.09.016. Epub 2017 Sep 29.
We investigated whether the value of ENoG is a predictive factor for the development of facial synkinesis in patients with facial palsy.
The degree of oral-ocular synkinesis was evaluated quantitatively by an asymmetry of the interpalpebral space width during the mouth movement (% eye opening). Twenty healthy volunteers without a history of facial palsy (12 men and 8 women; 25-65 years old; mean age: 42.3±9.7years) were included in the study to examine the normal range of % eye opening. Fifty-one patients with facial palsy including 38 with Bell palsy and 15 with herpes zoster oticus (28 men and 25 women; 11-86 years old; mean age: 54±19years) were enrolled to examine the relationship between the ENoG value 10-14days after the onset of facial palsy, and the % eye opening 12 months later. Receiver operating characteristic (ROC) curve for the ENoG value was then used to decide the optimum cut-off value as a predictor of the development of oral-ocular synkinesis.
We defined a % eye opening inferior to 85% as an index of the development of oral-ocular synkinesis. There was a significant correlation between the values of ENoG 10-14days after the onset of facial palsy and those of % eye opening 12 months later (ρ=0.81, p<0.001). The area under the ROC curve for the ENoG value was the predictor for the development of oral-ocular synkinesis at 0.913 (95%CI: 0.831-0.996, p<0.001). The optimum cut-off value of ENoG 10-14days after the onset of facial palsy was 46.5% to predict the development of oral-ocular synkinesis 12 months after the onset of facial palsy (sensitivity 97.1% and specificity 77.5%).
The value of ENoG 10-14days after the onset of facial palsy is a predictive factor for the development of facial synkinesis 12 months later. Since facial palsy patients with a ENoG value inferior to 46.5% have a high risk of developing synkinesis, they should receive the facial biofeedback rehabilitation with a mirror as a preventive therapy.
我们研究了面神经电图（ENoG）值是否为面瘫患者面部联动症发生的预测因素。
通过嘴巴运动时睑裂间距宽度不对称（%睁眼）来定量评估口眼联动程度。20名无面瘫病史的健康志愿者（12名男性和8名女性；年龄25 - 65岁；平均年龄：42.3±9.7岁）纳入研究以检测%睁眼的正常范围。51名面瘫患者，包括38名贝尔面瘫患者和15名耳带状疱疹患者（28名男性和25名女性；年龄11 - 86岁；平均年龄：54±19岁）被纳入研究，以检测面瘫发病10 - 14天后的ENoG值与12个月后的%睁眼之间的关系。然后使用ENoG值的受试者工作特征（ROC）曲线来确定作为口眼联动症发生预测指标的最佳截断值。
我们将%睁眼低于85%定义为口眼联动症发生的指标。面瘫发病10 - 14天后的ENoG值与12个月后的%睁眼值之间存在显著相关性（ρ = 0.81，p < 0.001）。ENoG值的ROC曲线下面积为0.913，是口眼联动症发生的预测指标（95%CI：0.831 - 0.996，p < 0.001）。面瘫发病10 - 14天后ENoG的最佳截断值为46.5%，以预测面瘫发病12个月后口眼联动症的发生（敏感性97.1%，特异性77.5%）。
面瘫发病10 - 14天后的ENoG值是12个月后面部联动症发生的预测因素。由于ENoG值低于46.5%的面瘫患者发生联动症的风险较高，他们应接受以镜子为辅助的面部生物反馈康复作为预防性治疗。
