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背景:面神经兴奋性阈值测试是判定失神经支配程度的一种方法,失神经支配程度与面神经病理变化是否对面神经功能的恢复有影响。目的:探讨面神经不同失神经支配程度的病理变化对面神经功能的影响。设计:临床的横断面观察研究和动物模型的非随机非对照实验研究。地点和对象:1976-01/1976-12在中国医科大学附属第一医院耳鼻咽喉科门诊和病房随机抽取既往无面神经麻痹(facialpalsy,FP)自愿受试者30例,男17例,女13例,年龄15～60岁;1975-01/2000-12在中国医科大学附属第一医院耳鼻咽喉科门诊就诊的既往无FP史,未经激素和物理疗法治疗的FP190例,男108例,女82例,年龄15～67岁;中国医科大学动物部提供豚鼠43只,体质量550～900g,雌雄不限。干预:应用神经兴奋性测试仪测试正常人双侧面神经兴奋性阈值的差值,进行重复性实验。测试FP者面神经的失神经支配程度。制作豚鼠颞骨内FP模型,应用诱发肌电图测试压迫面神经前后动作电位的反应阈值及通过瞬目反射观察面肌功能恢复时间。透射电镜观察面神经的病理变化。主要观察指标:临床研究观察面神经兴奋性阈值和各失神经支配组达到临床治愈天数;动物实验观察刺激反应阈值、神经纤维病变程度和瞬目反射恢复时间。结果:190例FP恢复到临床治愈,失神经支配阴性组需(33.1±21.3)d;
BACKGROUND: Facial nerve excitability threshold test is a method to determine the degree of denervation. Whether degree of denervation and facial nerve pathology influence the recovery of facial nerve function. Objective: To investigate the effects of different pathological changes of facial nerve denervation on facial nerve function. Design: Clinical cross-sectional study and animal model of non-randomized non-controlled experimental study. Location and subject: In the otolaryngology clinic and ward of the First Affiliated Hospital of China Medical University from January 1976 to July 1976, 30 volunteers were selected randomly from the former without facialpalsy (FP), including 17 males and 13 females , Aged 15-60 years old; FP190 cases without previous FP history without hormone and physical therapy in the First Affiliated Hospital of China Medical University from January 1975 to December 2000 were treated at Department of Otorhinolaryngology, 108 males and 82 females Cases, aged 15 to 67 years old; Animal Department of China Medical University to provide Guinea pig 43, body weight 550 ~ 900g, male or female. Intervention: The nerve excitability tester is used to measure the difference of the excitability thresholds of bilateral facial nerve in normal people, and the repetitive experiment is carried out. The degree of denervation of the facial nerve in FP was tested. The FP model of intraconeal bone in guinea pigs was made. The response threshold of electromyogram was recorded to test the action potentials before and after compression of facial nerve and the facial muscle recovery time was observed by blink reflex. Transmission electron microscopy was used to observe the pathological changes of facial nerve. MAIN OUTCOME MEASURES: Threshold of facial nerve excitability and the number of days of clinical cure in each denervated group were observed in clinical study. Threshold of stimulus response, degree of nerve fiber lesion and recovery time of blink reflex were observed in animal experiments. Results: 190 cases of FP recovered to clinical cure, denervated negative group need (33.1 ± 21.3) d;