末梢性顔面神経麻痺における耳小骨筋反射
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概要
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Since the stapedial muscle is an extraposed facial muscle, stapedial reflex should show a parallel change with that of the facial muscles.In the case of facial paralysis, stapedial reflex, like the Score Rating Method (May, 1975, Yanagihara, revised in 1977) and the Integrated EMG Method (Magi, 1980), reflects the degree of facial nerve damage.The stapedial reflex of an affected side induced by contralateral stimulation was compared with that of the unaffected side, and was expressed in a percentage, which we regarded as the degree of facial nerve damage.Three methods, namely the Score Rating Method, Integrated EMG Method and stapedial reflex were administered to 33 cases of peripheral facial paralysis. By applying the values measured in each method in a regression analysis, the onset of recovery and the termination date were determined.In the case of complete recovery, the stapedial reflex had late onset but its recovery rate was high and showed complete return. In the case of incomplete recovery, the stapedial reflex had late onset but it had a more rapid rate of recovery than that of the Score Rating method.The distribution of values of onset of stapedial reflex and the Score Rating method had a good correlation with that of the diameters of the fibers in the facial canal. The stapedial muscle is innervated by small fibers and stapedial reflex has a late onset, because in smaller fibers, injury is severer and recovery tends to be stagnated.
- 耳鼻咽喉科臨床学会の論文
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