Yanagida M
Department of Otorhinolaryngology, Kansai Medical University, Osaka.
Nihon Jibiinkoka Gakkai Kaiho. 1993 Aug;96(8):1329-39. doi: 10.3950/jibiinkoka.96.1329.
We performed enhanced MRI using Gd-DTPA in 84 patients with facial palsy. After assessing enhancement of the normal facial nerve, we examined enhancement in patients with Bell's palsy and Ramsay Hunt syndrome. The following results were obtained. 1. In 95% of patients with Bell's palsy, enhancement was obtained in the distal IAC and labyrinthine portions. In 72%, enhancement was significant from the distal IAC portion through the vertical portion. In some of the patients who underwent enhanced MRI twice, increased signal intensity was observed in distal portions such as the vertical portion. 2. In many cases with Ramsay Hunt syndrome, enhancement was seen extensively in the IAC portion through the vertical portion. In the subjects with internal auditory symptoms such as vertigo and tinnitus, enhancement of the IAC portion was seen not only in the facial nerve but also in the vestibular and the cochlear nerves. These results suggest that the vascular permeability of lesions in Bell's palsy may be increased from the distal IAC portion to the vertical portion. Judging from the present findings with Ramsay Hunt syndrome, symptoms related to the enhanced portions suggest that accompanying internal auditory symptoms occur due to inflammation of the IAC portions of cochlear and vestibular nerves.
我们对84例面神经麻痹患者使用钆喷酸葡胺进行了增强磁共振成像（MRI）检查。在评估了正常面神经的强化情况后，我们对贝尔麻痹和拉姆齐·亨特综合征患者的强化情况进行了检查。得到了以下结果。1. 在95%的贝尔麻痹患者中，内耳道远端和迷路段出现强化。在72%的患者中，从内耳道远端至垂直段强化明显。在一些接受了两次增强MRI检查的患者中，在垂直段等远端部位观察到信号强度增加。2. 在许多拉姆齐·亨特综合征病例中，在内耳道段至垂直段广泛出现强化。在有眩晕和耳鸣等内耳症状的受试者中，不仅面神经的内耳道段出现强化，前庭神经和蜗神经也出现强化。这些结果表明，贝尔麻痹病变的血管通透性可能从内耳道远端至垂直段增加。从目前拉姆齐·亨特综合征的研究结果来看，与强化部位相关的症状提示，伴随的内耳症状是由于蜗神经和前庭神经内耳道段的炎症所致。
