Bernardes Daniele Fontes Ferreira, Bento Ricardo Ferreira, Goffi Gomez Maria Valeria Schimidt
Department of Otorhinolaryngology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
Department of Otolaryngology, Universidade de São Paulo, São Paulo, SP, Brazil.
Int Arch Otorhinolaryngol. 2018 Oct;22(4):348-357. doi: 10.1055/s-0037-1607335. Epub 2017 Oct 26.
Surface electromyographic activity may not be symmetric, even in subjects with no facial paralysis history. To evaluate the contribution of the index of electromyographic (IEMG) activity in the identification of the two extremes of the facial paralysis course. Thirty-four subjects with unilateral peripheral facial paralysis were selected. A control group was composed of volunteers without a history of facial paralysis. The electromyographic assessment of the facial muscle was performed by placing surface electrodes during movements of the forehead, eyes and lips using MIOTEC equipment, such as the MIOTOOL (Miotec, Porto Alegre, Brazil) software. The electromyographic activity was also recorded in other channels during the primary activity to identify the presence of synkinesis. The statistical analysis was performed using the Statistical Package for Social Sciences for Macintosh (SPSS Inc, Chicago, IL, USA). The IEMG activity was obtained from the division of the electromyographic activity root mean square (RMS) values on both sides. There was a statistically significant difference among the groups in all the analyzed indexes. The ocular-oral synkinesis in all patients must be correctly identified (with 100% sensitivity and specificity) using an IEMG activity of 1.62 as a cutoff point. The oral-ocular synkinesis must be correctly identified (93.3% sensitivity and 95.9% specificity) using the IEMG activity of 1.79 as a cutoff point. The IEMG activity is below the normal scores in patients in the flaccid stage, whereas patients in the sequelae stage can either show normal values or values above or below the normal scores. The IEMG activity was shown to have high sensitivity and specificity in the identification of synkinesis.
即使在没有面瘫病史的受试者中，表面肌电图活动也可能不对称。为了评估肌电图（IEMG）活动指数在识别面瘫病程两个极端情况中的作用。选取了34例单侧周围性面瘫患者。对照组由无面瘫病史的志愿者组成。使用MIOTEC设备（如MIOTOOL软件，巴西阿雷格里港的Miotec公司），在前额、眼睛和嘴唇运动期间放置表面电极，对面部肌肉进行肌电图评估。在主要活动期间，还在其他通道记录肌电图活动，以识别联带运动的存在。使用适用于Macintosh的社会科学统计软件包（美国伊利诺伊州芝加哥的SPSS公司）进行统计分析。IEMG活动通过两侧肌电图活动均方根（RMS）值的除法获得。在所有分析指标中，各组之间存在统计学显著差异。以1.62的IEMG活动作为截断点，所有患者的眼口联带运动必须被正确识别（敏感性和特异性均为100%）。以1.79的IEMG活动作为截断点，口眼联带运动必须被正确识别（敏感性为93.3%，特异性为95.9%）。在弛缓期患者中，IEMG活动低于正常分数，而后遗症期患者的IEMG活动可能显示正常数值，也可能高于或低于正常分数。IEMG活动在识别联带运动方面具有高敏感性和特异性。
