Ristić B, Kitanoski B, Matković S
Klinika za uvo, nos i grlo, Vojnomedicinska akademija, Beograd.
Med Pregl. 1998 Sep-Oct;51(9-10):400-3.
In all lesions of the facial nerve suprachoroidally localized, and due to disturbance of parasympathetic and sympathetic component, there comes to qualitative and quantitative disorders of the secretion of submandibular salivary gland. Glandular immunoglobulins IgA and IgG are the secretion of the specific plasma cells in the interstice of this gland. The mechanism of the secretion of immunoglobulins is not sufficiently clear, but it is certainly under the direct neurogenic control, since the disorders of the secretion emerge after the denervation of the submandibular salivary gland. The aim of the study was to prove the direct relation between the degree of submandibular immunoglobulin secretion IgA and IgG, and the degree of the lesion of the facial nerve U which is vitally important in the clinical estimation of the peripheral paralysis of this nerve.
In 35 patients with peripheral idiopathic facial nerve paralysis, the quantity of the secreted immunoglobulins IgA and IgG was examined by laser nephelometar BLN, Module 3. The quantity of the secreted immunoglobulins IgA and IgG (mg lit) in the saliva of the paralysed side was indirectly compared to the secreted immunoglobulins of the healthy, i.e. control side. The examination was performed three times: a) after the appearance of the disease, in the first 30 days; b) two to three months later; c) after six to twelve months.
The quantity of the secreted immunoglobulins is significantly higher in the saliva samples taken from the paralysed side (9.50U204.77 mg lit), in comparison with the samples taken from the healthy side (9.50U70.36 mg lit). In the group of patients with favourable results and significantly higher secretion (p 0.01) normalization occurred in the final period of observation. In patients with unfavourable results the difference in secretion was continuously present (p 0.05) (table 1).
In the lesions of the facial nerve suprachoroidally localized, there comes to disorder concerning the secretion of immunoglobulins IgA and IgG by submandibular salivary gland, which can be applied in the estimation of the degree of paralysis and the prognosis of the final result.
The results of the research show that in the peripheral idiopathic facial nerve paralysis, there comes to increased secretion of immunoglobulins IgA and IgG in submandibular gland, at the paralysed side. In the patients who, during the paralysis, show quicker fall and normalization of the previously increased quantities of immunoglobulins, the recovery of the motor function of the facial nerve comes more successfully and more certainly. The degree of the secretion of immunoglobulins IgA and IgG can be used for the estimation of the severely of the pathological process in the suprachoroidal part of the nerve, and it can be used as a reliable parameter for the prognosis of the paralysis outcome.
在所有面神经脉络膜上局部病变中，由于副交感和交感成分的紊乱，下颌下唾液腺的分泌会出现质和量的异常。腺性免疫球蛋白IgA和IgG是该腺体间隙中特异性浆细胞的分泌物。免疫球蛋白的分泌机制尚不完全清楚，但肯定受直接神经源性控制，因为下颌下唾液腺去神经支配后会出现分泌紊乱。本研究的目的是证明下颌下免疫球蛋白IgA和IgG的分泌程度与面神经U损伤程度之间的直接关系，这在该神经周围性麻痹的临床评估中至关重要。
对35例周围性特发性面神经麻痹患者，采用激光散射比浊法BLN模块3检测分泌的免疫球蛋白IgA和IgG的量。将患侧唾液中分泌的免疫球蛋白IgA和IgG（mg/lit）的量与健侧即对照侧分泌的免疫球蛋白进行间接比较。检查进行了三次：a）发病后第1个月内；b）两到三个月后；c）六到十二个月后。
与健侧样本（9.50±70.36mg/lit）相比，患侧唾液样本中分泌的免疫球蛋白量显著更高（9.50±204.77mg/lit）。在预后良好且分泌显著更高（p<0.01）的患者组中，在观察末期出现了正常化。预后不良的患者分泌差异持续存在（p<0.05）（表1）。
在面神经脉络膜上局部病变中，下颌下唾液腺分泌免疫球蛋白IgA和IgG出现紊乱，这可用于评估麻痹程度和最终结果的预后。
研究结果表明，在周围性特发性面神经麻痹中，患侧下颌下腺免疫球蛋白IgA和IgG的分泌增加。在麻痹期间，先前增加的免疫球蛋白量下降更快且恢复正常的患者，面神经运动功能的恢复更成功、更确定。免疫球蛋白IgA和IgG的分泌程度可用于评估神经脉络膜上部分病理过程的严重程度，并可作为麻痹预后的可靠参数。
