Heo Min Young, Choi Seongmin, Shim Ga Yang, Soh Yunsoo, Chon Jinmann, Yoo Myung Chul
Department of Physical Medicine & Rehabilitation, Kyung Hee University Medical Center, Seoul, Republic of Korea.
Department of Physical Medicine & Rehabilitation, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
Eur Arch Otorhinolaryngol. 2025 May 15. doi: 10.1007/s00405-025-09419-4.
To integrate the results from multiple electrophysiological tests, which has the potential to significantly improve outcome predictions in patients with Bell's palsy.
This retrospective study analyzed 193 patients who were diagnosed with Bell's palsy at our Department of Physical Medicine & Rehabilitation, from January 2020 to December 2022. All patients were followed for at least 6 months, with a mean follow-up duration of 6.8 months (range: 6-9 months). Clinical data, including House-Brackmann (H-B) grade and electrophysiological data from five tests, were analyzed using multiple logistic regression analysis and decision tree analysis to predict outcome at 6 months. The five electrophysiological tests were: electroneurography degeneration index (ENoG DI), compound muscle action potential (CMAP) latency, blink reflex (BR), nerve excitability test (NET), and needle electromyography (nEMG).
The decision tree model identified five key predictors of recovery: ENoG DI in the orbicularis oculi, initial H-B grade, interference pattern in orbicularis oculi, NET difference, and CMAP latency in the frontalis. Patients with an ENoG DI < 71.72% and initial H-B grade ≤ 3 had a high probability of complete recovery. For higher ENoG DI values, a NET difference ≥ 4.50 mA and CMAP latency > 3.80 ms predicted incomplete recovery. This analysis led to an overall accuracy of 86.01%.
This study demonstrated that the combined use of initial H-B grade with the results from multiple electrophysiological results provided reliable outcome predictions in patients with Bell's palsy.
整合多项电生理测试结果，这有可能显著改善贝尔麻痹患者的预后预测。
这项回顾性研究分析了2020年1月至2022年12月在我院物理医学与康复科被诊断为贝尔麻痹的193例患者。所有患者均随访至少6个月，平均随访时间为6.8个月（范围：6 - 9个月）。使用多元逻辑回归分析和决策树分析对包括House - Brackmann（H - B）分级在内的临床数据以及五项测试的电生理数据进行分析，以预测6个月时的预后。五项电生理测试分别为：神经电图变性指数（ENoG DI）、复合肌肉动作电位（CMAP）潜伏期、瞬目反射（BR）、神经兴奋性测试（NET）和针极肌电图（nEMG）。
决策树模型确定了恢复的五个关键预测因素：眼轮匝肌的ENoG DI、初始H - B分级、眼轮匝肌的干扰型、NET差值以及额肌的CMAP潜伏期。ENoG DI < 71.72%且初始H - B分级≤3的患者完全恢复的可能性很高。对于较高的ENoG DI值，NET差值≥4.50 mA且CMAP潜伏期> 3.80 ms预测恢复不完全。该分析的总体准确率为86.01%。
本研究表明，将初始H - B分级与多项电生理结果相结合可为贝尔麻痹患者提供可靠的预后预测。
