Murakawa K, Minatogawa T, Amatsu M
Department of Anesthesiology, Hyogo College of Medicine, Japan.
Kobe J Med Sci. 1993 Aug;39(4):147-59.
Impairment of microcirculation of the facial nerves is considered to play an important role in etiology of facial palsy, and the main emphasis of the conservative treatment is aimed at circulatory improvement. Therefore, at the pain clinic, improved blood flow to the facial nerve by chemical blockage of cervical sympathetic trunks (stellate ganglion block; SGB) is employed in treating patients with facial palsy. The circulatory effects of SGB were clinically determined in 20 patients with acute Bell's palsy, and the effects of chemical blockage of cervical sympathetic trunks on the tissue circulation of facial nerve were also experimentally evaluated in dogs. In the clinical study, the blood flow volume of the common carotid artery increased significantly in 5 minutes after SGB, and has reached its peak of 176.4% in 20 minutes. This significant increase continued up to 75 minutes. In the animal model experiments, the common carotid arterial blood flow volume increased immediately after performing experimental SGB with a peak rise of 143.5% in 15 minutes, and the significant increase continued up to 45 minutes. The blood flow volume in the facial nerve tissue also increased for 5 minutes with a peak rise of 115.2% in 20 minutes after SGB, and this significant increase persisted for up to 60 minutes. A marked increase was observed in the blood flow volume in the facial nerve tissue as well as through the common carotid artery. The circulatory improvement performed by SGB extended as far as the facial nerve itself. From the facts above mentioned, SGB is considered to be an extremely effective treatment for the Bell's palsy.
面神经微循环障碍被认为在面瘫病因中起重要作用，保守治疗的主要重点是改善循环。因此，在疼痛诊所，通过化学阻断颈交感干（星状神经节阻滞；SGB）来改善面神经血流，用于治疗面瘫患者。对20例急性贝尔面瘫患者进行了SGB的循环效应临床测定，并在犬类动物上对颈交感干化学阻断对面神经组织循环的影响进行了实验评估。在临床研究中，SGB后5分钟颈总动脉血流量显著增加，20分钟时达到峰值176.4%。这种显著增加持续到75分钟。在动物模型实验中，进行实验性SGB后颈总动脉血流量立即增加，15分钟时峰值上升143.5%，显著增加持续到45分钟。SGB后面神经组织血流量也增加5分钟，20分钟时峰值上升115.2%，这种显著增加持续到60分钟。面神经组织以及颈总动脉的血流量均显著增加。SGB所实现的循环改善延伸至面神经本身。基于上述事实，SGB被认为是治疗贝尔面瘫的极其有效的方法。
