1994 Fiscal Year Final Research Report Summary
A study of intratemporal facial nerve entrapment palsy. -Its early diagnosis and treatment-
| Project/Area Number |
05671433
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Otorhinolaryngology
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| Research Institution | Kochi Medical School |
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Principal Investigator |
SAITO Haruo Kochi Medical School, Dept of Otolaryngology professor, 医学部, 教授 (20026917)
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| Co-Investigator(Kenkyū-buntansha) |
NAKAHIRA Mitsuhiko Kochi Medical School, Dept of Otolaryngology Instructor, 医学部, 助手 (10253353)
NAKATANI Hiroaki Kochi Medical School, Dept of Otolaryngology Assistant professor, 医学部, 講師 (60172334)
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| Project Period (FY) |
1993 – 1994
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| Keywords | Facial nerve / Facial paralysis / Entrapment palsy / Nerve decompression / Physiological testing / Magnetic stimulation / Antidromic nerve response |
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| Research Abstract |
We have been engaged in researches on tasting and management of facial palsy. Supported by the grants, we performed series of experimental and clinical studies. Using our animal model of ischemic facial palsy, we extended the studies to improve treatments of facial palsy and accurate testing for prognosis of facial palsy.
Steroids have been clinically used in initial stage of facial palsy. Its effect is based on only clinical experience. Our histopathological studies of the ischemic facial palsy in guinea pigs showed that interstitial edema decreased greatly after administration of steroid, and that hydrocortisone prevented initial edema of the damaged nerve preventing its entrapment in the narrow facial canal. This was the first histopathological report of its effect and the basis. Our clinical study showed that peroral administration of glycerol was effective in early cases of Bell's palsy and prevented pathologic synkinetic movements after recovery of mimic movement.
There are cases with Bell's palsy which need surgical decompression even with the use of steroids and glycerol (hyperosmotic diuretics). Conventional electrophysiological testings, such as ENoG,are not effective for selecting surgical cases. The site, degree, and recovering phase of the ischemic palsy could be monitored by antidromic facial nerve response in guinea pigs and also in clinical cases. Recovery from the palsy was faster and the out-comes were better in the cases chosen and decompressed in early phase of palsy by the antidromically evoked facial nerve response stimulated through Stensen's duct.
Magnetic orthodromic intracranial facial nerve stimulation is one of the promising methods to detect early changes of the intratemporal segment of the facial nerve. Our study showed that its use was still not practical mainly because of large diameter of commercially available stimulating coils.
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