逆行诱发电位对贝尔面瘫的定位研究

目的：应用逆行诱发电位（facial nerve antidromical evoked potentials,FNAEP）对贝尔面瘫患者进行病变部位的定位。方法：对2009年1～12月就诊于上海第九人民医院口腔颌面外科神经疾患专科的46例贝尔面瘫患者进行FNAEP检查,其中非味觉障碍组20例,味觉障碍组26例.刺激点为茎乳孔体表投影处,记录点为外耳道后壁,对波形特点进行分析。结果：味觉障碍组中,外耳道后壁记录点示健患侧潜伏期、波幅均存在统计学差异,潜伏期差值比均数为（14.71±5.18）%,波幅差值比均数为（-33.88±33.04）%,与临床症状的阳性符合率分别为23/26（88.46%）和24/26（92.31%）。非味觉障碍组中,外耳道后壁记录点示健患侧潜伏期、波幅无统计学差异,患侧AEP潜伏期、波幅数据与临床症状相比较,阴性符合率分别为9/20（45.00%）、10/20（50.00%）。结论：当外耳道后壁记录潜伏期及波幅的患健侧差值比的绝对值分别达到10%及30%以上,提示垂直段的损伤。

Antidromica Evoked Potentials for Positioning in Facial Paralysis

Objective：To position the affected region of the facial nerve in the patients with Bell＇s palsy by facial nerve antidromica evoked potentials（FNAEP）.Methods：46 patients suffered from Bell＇s palsy were tested by FNAEP.26 patients complained with dysgeusia,and the other 20 patients without dysgeusia.The body projection of stylomastoid foramen was set as the stimulating point while the back wall of external acoustic meatus was set as the recording point.The latency and the amplitude of the symptomatic side and asymptomatic side were recorded.Results：In cases with dysgeusia,the data got from the back wall of external acoustic meatus showed that the latency and the amplitude were statistically different between the symptomatic side and asymptomatic side.The mean difference of the latency was 14.71%±5.18%,the mean difference of the amplitude was -33.88%±33.04%,and the positive correspondence rate to clinical symptom were 23/26（88.46%） and 24/26（92.31%） respectively.In cases without dysgeusia,the data got from the back wall of external acoustic meatus showed that the latency and the amplitude were not statistically different between the symptomatic side and asymptomatic side.Their negative correspondence rate to clinical symptom were 9/20（45.00%） and 10/20（50.00%） respectively.Conclusion：The damage of the facial nerve vertical part could be positioned when the record point was set at the back wall of external acoustic meatus and the difference of the latency and the amplitude between the symptomatic side and asymptomatic side were arose to 10% and 30% respectively.