Wang Y, Zhang S, Xu H
Second Hospital, Tianjin Medical University.
Zhonghua Er Bi Yan Hou Ke Za Zhi. 1996;31(6):334-7.
In order to research the relationship between various methods of treatment and their prognosis on Bell's palsy, 164 cases of Bell's Palsy were reviewed. According to the results of ENoG test, 164 cases were divided into three groups A, B1 and B2. Group A: the paretic side ENoG loss was less than 90%, group B1: the ENoG loss was more than 90% and without surgical decompression of facial nerve, group B2: the ENoG loss was more than 90% and with surgical decompression. All of the patients had follow up for 1-3 years or even longer after onset. The grades of recovery of facial function were evaluated by modified classification system as originally proposed by Portmann. The facial function of 77 cases of group A were recovered satisfactorily except 3 patients, the average points were 19.22 +/- 1.18. The average points of group B1 (41 cases) and B2 46 cases were 14.4 +/- 3.49 and 15.4 +/- 2.08 respectively. Comparing the results with group B1, B2 and A, there was no statistical significant difference (P > 0.05) between group B1 and B2, but the results of group A were statistically significant better than group B1 and B2 (P < 0.01). The prognosis of Bell's palsy might mainly depend on the degree of degeneration of facial nerve. A satisfactory recovery can be expected when ENoG test loss was less than 90%. If ENoG loss was more than 90%, neither surgical decompression nor steroids therapy could change the prognosis statistically.
为了研究贝尔面瘫的各种治疗方法与其预后之间的关系，回顾性分析了164例贝尔面瘫患者。根据神经电图（ENoG）测试结果，将164例患者分为A、B1和B2三组。A组：患侧ENoG损失小于90%；B1组：ENoG损失大于90%且未行面神经减压术；B2组：ENoG损失大于90%且行了面神经减压术。所有患者发病后均随访1 - 3年甚至更长时间。采用Portmann最初提出的改良分类系统对面部功能恢复程度进行评估。A组77例患者中，除3例患者外，其余患者面部功能恢复良好，平均评分为19.22±1.18。B1组（41例）和B2组（46例）的平均评分分别为14.4±3.49和15.4±2.08。将B1组、B2组与A组结果进行比较，B1组和B2组之间无统计学显著差异（P>0.05），但A组结果在统计学上显著优于B1组和B2组（P<0.01）。贝尔面瘫的预后可能主要取决于面神经的变性程度。当ENoG测试损失小于90%时，有望获得满意的恢复。如果ENoG损失大于90%，无论是手术减压还是类固醇治疗在统计学上都无法改变预后。
