口轮匝肌双侧神经电图测试意义的临床和实验探讨  

Clinical and experimental study of bilateral electroneurogram measurement on musculus orbicularis oris

作　　者：于何[1] 任子涵[1] 任重[1] 姜学钧[1] 

机构地区：[1]中国医科大学第一临床学院耳鼻咽喉科,辽宁沈阳110001

出　　处：《解剖科学进展》2010年第2期138-139,142,共3页Progress of Anatomical Sciences

摘　　要：目的通过口轮匝肌双侧神经电图测试,探讨口轮匝肌的神经支配及面神经麻痹侧眼轮匝肌和口轮匝肌受损伤程度差异。方法测试正常人30人,面瘫患者152例的双侧神经电图(ENoG),并计测非刺激侧(患侧)对刺激侧(健侧)的振幅百分比值。其中失神经支配阴性组52例,失神经支配I度组41例,Ⅱ度组32例,Ⅲ度组27例。制作豚鼠压榨性面瘫实验模型,分别计测第1次加压5秒组和第2次加压5秒组的口轮匝肌双侧ENoG,并分别计测出第一次压榨组和第二次压榨组压榨后非刺激侧振幅值和刺激侧振幅值。结果面瘫组非刺激侧(患侧)对刺激侧(健侧)双侧ENoG振幅比值失神经支配Ⅲ度组显著大于Ⅱ度组(P<0.05),失神经支配Ⅱ度组显著大于Ⅰ度组(P<0.05),失神经支配Ⅰ度组显著大于失神经支配阴性组,失神经支配阴性组显著大于正常人组(P<0.05)。实验动物组第2次压榨组非刺激侧振幅值显著大于第1次压榨组(P<0.05),第1次压榨组非刺激侧振幅值显著大于压榨前振幅值(P<0.05)。结论口轮匝肌受双侧面神经支配是面神经失神经支配后口轮匝肌比眼轮匝肌受损伤程度小的原因之一。患侧对健侧振幅百分比值越大,患侧面神经受损伤程度越重。Objective To explore the innervation of musculus orbicularis oris（m.oris）and the vulnerability differences between m.oris and musculus orbicularis oculi in facial paralysis.Methods The bilateral electroneuronography（ENoG）was measured in patients with facial paralysis（n=152）and normal men（n=31）,and the ratio of ENoG amplitude of non-stimulated side（affected side）vs stimulated side（normal side）was calculated.The facial paralysis model of guinea pig was made by compression of facial nerve for the first 5 seconds and the second 5 seconds,and bilateral ENoG of m.oris was measured separately,the ENoG amplitude was also recorded after each compressing.Results The ratio of ENoG amplitude of affected side vs normal side is significantly higher in 3 degree denervation group than in 2 degree denervation group（P0.05）,is higher in 2 degree denervation group than in 1 degree denervation group（P0.05）,is higher in 1 degree denervation group than in the normal group.In experiment group of animals,the amplitude of non-stimulated side is significantly higher in compressing 10s group than in compressing 5s group（P0.05）which is higher than in normal group.Conclusion Bilateral innervation of m.oris might be one of the reasons that m.oris was less valnerable than musculus orbicularis oculi.

关 键 词：面神经麻痹 口轮匝肌 双侧神经电图 

分 类 号：R745.12[医药卫生—神经病学与精神病学]