Gantz B J, Gmür A, Fisch U
Am J Otolaryngol. 1982 Jul-Aug;3(4):273-8. doi: 10.1016/s0196-0709(82)80066-5.
The technique of intraoperative evoked electromyography is described in detail. Direct intraoperative stimulation of the exposed facial nerve identified the sites of nerve impulse conduction blocks in 16 of 18 patients who needed decompression for Bell' s palsy. In order to determine the site of impulse conduction block the test must be performed before 100 per cent nerve degeneration occurs. The lesions extended only a few millimeters and were found to be proximal to the geniculate ganglion in 15 (94 per cent) of these patients. Schirmer's test correctly identified the sites of the lesions in only 61 per cent of the patients. To locate the precise site of the lesion inducing a conduction block in Bell's palsy, intraoperative evoked electromyography must be used. The limited extent of the blocked motor fibers indicates that segmental rather than total intratemporal decompression is needed in Bell's palsy.
术中诱发肌电图技术已得到详细描述。在18例因贝尔面瘫需要减压的患者中，有16例通过术中直接刺激暴露的面神经确定了神经冲动传导阻滞部位。为了确定冲动传导阻滞的部位，必须在神经发生100%变性之前进行该测试。病变仅延伸几毫米，在这些患者中有15例（94%）发现病变位于膝状神经节近端。施密特试验仅在61%的患者中正确识别出病变部位。为了定位贝尔面瘫中诱发传导阻滞的病变的确切部位，必须使用术中诱发肌电图。运动纤维阻滞范围有限表明贝尔面瘫需要节段性而非全颞骨内减压。
