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首页> 外文期刊>Otolaryngology--head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery >Effect of long-term electrical stimulation on motor recovery and improvement of clinical residuals in patients with unresolved facial nerve palsy.
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Effect of long-term electrical stimulation on motor recovery and improvement of clinical residuals in patients with unresolved facial nerve palsy.

机译：长期电刺激对面神经麻痹未解决患者运动恢复和临床残留改善的影响。

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PURPOSE: This study investigated the efficacy of a pulsatile electrical current to shorten neuromuscular conduction latencies and minimize clinical residuals in patients with chronic facial nerve damage caused by Bell's palsy or acoustic neuroma excision. SUBJECTS: The study group included 12 patients (mean age 50.4 +/- 12. 3 years) with idiopathic Bell's palsy and 5 patients (mean age 45.6 +/- 10.7 years) whose facial nerves were surgically sacrificed. The mean time since the onset of paresis/paralysis was 3.7 years (range 1-7 years) and 7.2 years (range 6-9 years) for the Bell's and neuroma excision groups, respectively.Method And Procedures: Motor nerve conduction latencies, House-Brackmann facial recovery scores, and a 12-item clinical assessment of residuals were obtained 3 months before the onset of treatment, at the beginning of treatment, and after 6 months of stimulation. Patients were treated at home for periods of up to 6 hours daily for 6 months with a battery-powered stimulator. Stimulation intensity was kept at a submotor level throughout the study. Surface electrodes were secured over the most affected muscles. Groups and time factors were used in the analyses of the 3 outcome measures. RESULTS: No statistical differences were found between the two diagnostic groups with respect to any of the 3 outcome measures. Mean motor nerve latencies decreased by 1.13 ms (analysis of variance test, significant P = 0.0001). House-Brackmann scores were also significantly lower (Wilcoxon signed rank test, P = 0.0003) after treatment. Collective scores on the 12 clinical impairment measures decreased 28.7 +/- 8.1 points after 6 months [analysis of variance test, significant P = 0.0005). Eight patients showed more than 40% improvement, 4 better than 30%, and 5 less than 10% improvement in residuals score. CONCLUSION: These data are consistent with the notion that long-term electrical stimulation may facilitate partial reinnervation in patients with chronic facial paresis/paralysis. Additionally, residual clinical impairments are likely to improve even if motor recovery is not evident.
机译：目的：本研究调查了脉冲电流可缩短因贝尔麻痹或听神经瘤切除引起的慢性面神经损伤的患者的神经肌肉传导潜伏期并最大程度减少临床残留的功效。研究对象：研究组包括12例特发性贝尔麻痹的患者（平均年龄50.4 +/- 12岁。3岁）和5例通过手术牺牲的面部神经患者（平均年龄45.6 +/- 10.7岁）。自贝尔氏和神经瘤切除术组麻痹/麻痹发作以来的平均时间分别为3.7年（1-7岁）和7.2年（6-9岁）。方法和步骤：运动神经传导潜伏期在治疗开始前3个月，治疗开始时和刺激6个月后，获得-Brackmann面部恢复评分和12项残渣临床评估。使用电池供电的刺激器，每天在家接受长达6个月的治疗，为期6个月。在整个研究过程中，刺激强度保持在亚运动水平。表面电极固定在受影响最大的肌肉上。分组和时间因素被用于3种结果测量的分析。结果：在这三个结果指标中，两个诊断组之间均未发现统计学差异。平均运动神经潜伏期减少了1.13 ms（方差分析分析，显着P = 0.0001）。治疗后，House-Brackmann评分也显着降低（Wilcoxon符号秩检验，P = 0.0003）。 6个月后，对12种临床损伤措施的总体评分下降了28.7 +/- 8.1分[方差分析分析，显着P = 0.0005）。 8例患者的残差评分改善了40％以上，4例改善了30％以上，5例改善了10％以下。结论：这些数据与长期电刺激可促进慢性面部轻瘫/瘫痪患者的部分神经支配的观点一致。此外，即使运动恢复不明显，残余的临床损伤也可能会改善。

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