Fujiwara Keishi, Furuta Yasushi, Yamamoto Naoko, Katoh Kanako, Fukuda Satoshi
Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-Ku, N15W7, Sapporo 0608638, Hokkaido, Japan.
Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-Ku, N15W7, Sapporo 0608638, Hokkaido, Japan; Department of Otolaryngology, Head and Neck Surgery, Teine-Keijinkai Hospital, 12-1-40, Maeda 1-jo, Teine-Ku, Sapporo 0068555, Hokkaido Japan.
Auris Nasus Larynx. 2018 Aug;45(4):732-739. doi: 10.1016/j.anl.2017.10.003.
To investigate factors affecting the effect of physical rehabilitation therapy for synkinesis as a sequela to facial nerve palsy.
A total of 37 patients with peripheral facial nerve palsy in Teine-Keijinkai Hospital were enrolled in this study. All patients showed synkinesis at 6 months after the onset of facial nerve palsy and were instructed in physical rehabilitation by expert staff from their first visit. The degree of synkinesis was evaluated at 6, 9 and 12 months after the onset of facial nerve palsy based on Sunnybrook facial grading system score and asymmetry in eye opening width. The patients were divided into two groups by age, gender, cause of palsy, electroneurography (ENoG) value, onset of synkinesis, initial treatment and timing of the start of physical rehabilitation.
Female patients and younger patients did not show any deterioration in synkinesis. Patients in the lower ENoG group and the later onset of synkinesis group showed significant deterioration in synkinesis after the 6th month from onset of facial palsy.
Physical rehabilitation was shown to prevent significant deterioration in synkinesis in female and younger patients with facial nerve palsy. Careful follow-up with regard to synkinesis is required in cases in which the facial nerve damage is thought to be severe.
探讨影响面神经麻痹后遗症联动症物理康复治疗效果的因素。
本研究纳入了帝京平成会医院的37例周围性面神经麻痹患者。所有患者在面神经麻痹发病6个月时均出现联动症，并从首次就诊起由专业人员指导进行物理康复治疗。根据桑尼布鲁克面部分级系统评分和睁眼宽度不对称性，在面神经麻痹发病后6、9和12个月评估联动症程度。根据年龄、性别、麻痹原因、神经电图（ENoG）值、联动症发病时间、初始治疗情况以及开始物理康复治疗的时间将患者分为两组。
女性患者和年轻患者的联动症未出现任何恶化。ENoG值较低组和联动症发病较晚组的患者在面神经麻痹发病6个月后联动症出现显著恶化。
物理康复治疗被证明可预防女性和年轻面神经麻痹患者联动症的显著恶化。对于面神经损伤被认为严重的病例，需要对面部联动症进行仔细随访。
