| Project/Area Number |
60304072
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| Research Category |
Grant-in-Aid for Co-operative Research (A)
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| Allocation Type | Single-year Grants |
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| Research Field |
Otorhinolaryngology
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| Research Institution | Yamagata University |
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Principal Investigator |
KOIKE Yoshio Professor, Department of Otolaryngology, Yamagata University, School of Medicine., 医学部, 教授 (70018357)
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| Co-Investigator(Kenkyū-buntansha) |
NOMURA Yasuya Professor, Department of Otolaryngology, Tokyo University, School of Medicine., 医学部・耳鼻咽喉科, 教授 (30009948)
MATSUNAGA Tooru Professor, Department of Otolaryngology, Osaka University, School of Medicine., 医学部・耳鼻咽喉科, 教授 (10101271)
KUMAGAMI Hidehaku Professor, Department of Otolaryngology, Nagasaki University, School of Medicine, 医学部・耳鼻咽喉科, 教授 (50039492)
TOMITA Hiroshi Professor, Department of Otolaryngology, Nihon University, School of Medicine., 医学部・耳鼻咽喉科, 教授 (60058964)
YANAGIHARA Naoaki Professor, Department of Otolaryngology, Ehime University, School of Medicine., 医学部・耳鼻咽喉科, 教授 (40025581)
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| Project Period (FY) |
1984 – 1986
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| Project Status |
Completed (Fiscal Year 1986)
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| Budget Amount *help |
¥15,000,000 (Direct Cost: ¥15,000,000)
Fiscal Year 1986: ¥5,300,000 (Direct Cost: ¥5,300,000)
Fiscal Year 1985: ¥9,700,000 (Direct Cost: ¥9,700,000)
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| Keywords | Idiopathic facial palsy / Incidence in general population / Epidemiology / Viral infection / Facial nerve examination / Early prognostic diagnosis / Steroid therapy / 混合静注法 / 抗ウイルス剤 / 麻痺評価法(日本案) |
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| Research Abstract |
This nation-wide epidemiological research project on the idiopathic facial palsy through the cooperation of 28 medical facilities started at the beginning of 1984 for a planned period of 3 years. The results are summarized in 5 categories.
(1) Incidence; With regard to accurate statistics as a function of each prefecture, the incidence of Bell's palsy in general population was found to be 20-30/100,000. These rate are almost similar to those in Europe and the United States. These rate are about 2 times larger than that of Meniere's disease and 1.25 times as large as that of sudden deafness. The close relationship between climate and the incidence of facial palsy was not found. The incidence of Hunt's syndrome was only about 20% of that of Bell's palsy.
(2) Viral infection; Viral participation was detectable in 3 to 18% of the patients diagnosed as Bell's palsy. As participated virus, varicella zoster virus, influenza A virus, influenza B virus and herpes simplex virus were suspected. The
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infection rate was high in Tokyo and Keihansin districts, which have high population densities. A high correlation between the incidence of facial palsy and viral epidemics was found.
(3) Diagnostic examination; NET, electroneuronography and evoked EMG are popularly used as the most reliable methods.
(4) Therapeutic method; Facial nerve decompression was performed in only 4.2% of the patients, and the judgment that facial nerve decompression is not effective except for its early stage application has been established. Regarding conservative therapy, early stage administration of steroids is effective in Bell's palsy and even in Hunt's syndrome. It is now being confirmed that combined infusion therapy using low molecular dextran improve the cure rate. Antiviral agents cannot be said to be effective in the treatment of Hunt's syndrome when it is employed at the onset of facial palsy.
(5) Cure rate; Complete recovery rate was 52.1% in Bell's palsy and 59.0% in Hunt's syndrome. However, there were 29.2% of unknown outcome cases. Thus, cure rate was found to change depending on how to handle these unknown outcome cases. Less
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