顔面神経麻痺における大錐体神経機能検査の評価

Abstract

We coducted electrogustometry (EGM) of the soft palate as a functional test of the greater petrosal nerve (GPN) in patients with acute peripheral facial paralysis and compared these findings with results of the Schirmer's test.One hundred fifteen cases,59 males and 56 females were examined. Seventy-eight cases had Bell's palsy,27 cases Ramsay Hunt syndrome and 10 cases zoster sine herpete. Dysfunction of the stapedial nerve was recognized in all cases.An electrogustometer (TR-5, Rion ) was used for the taste test. The elevation of the threshold more than 6 dB on the affected side was considered abnormal. To evaluate lacrimal function, the Schirmer's test was used. Lacrimal secretion on the affected side was considered abnormal when the secretion was decreased to less than 50% of that on the non-affected side.The following results were obtained.1.28.2% of 78 cases of the B ell's palsy showed taste disturbance of the soft palate, and 10.3%showed lacrimal dysfunction. It was supposed that the EGM of the soft palate was more sensitive than the Schirmer's test for evaluating of dysfunction of the GPN in facial nerve palaysis.2. Only 9 (28.1%) of 32 cases with taste dysfunction also showed lacrimal dysfu nction. It was suspected that the affected nerve fibers differ somewhat in between the sensory and secretory nerve fibers of the GPN.3. Findings of Schirmer's test were more related with the severity of the facial paralysis and with the prognosis of paralysis than those of EGM.