逆行性顔面神経誘発電位の臨床応用-経耳下腺管刺激法-

概要

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The facial nerve was stimulated via the parotid duct to record the antidromically evoked facial nerve response in13normal subjects. A patient with chronic otitis media operated on with the open method and another patient whose intratemporal facial canal was exposed intraoperatively were also studied as control subjects. A thin stimulating catheter electrode was inserted into the parotid duct. The nerve potential was recorded in the external auditory canal near the eardrum.<BR>The response recorded in the external auditory canal consisted of a small potential complex with short latency and a large potential complex with long latency. The potential with long latency had similar latency of compound muscle action potentials recorded simultaneously from the orbicularis oris muscle. Changes of latency, with moving the stimulating site or the recording site, showed that a small potential was elicited from more central portion of the facial nerve than a stimulating site. The potential with long latency disappeared under a muscle relaxant intraoperatively. The facts showedthat the potential with short latency was the antidromically evoked facial nerve response and another was compound muscle action potentials of the facial mimic muscles. Identification of the nerve potential was easy, because stimulation via the parotid duct diminished the initial stimulating artifacts.