| This paper consisted of three parts including the diagnostic usefulness of F waves in early stage of the peripheral facial paralysis, laser Doppler flowmetry study on facial nerve and the effect of the bFGF target muscle injection on prevent atrophy after facial nerve transaction in rabbits. The abstract was as follows:Part 1 The diagnostic usefulness of F waves in early stage of the peripheral facial paralysis.OBJECTIVE: F wave had been used as an objective electrodiagnostic method for detect the early disorder in the proximal segment of the facial nerve. The purpose of this follow-up study is to assess the prognostic usefulness of F waves in early stage of the peripheral facial paralysis. METHODS: The test results were evaluated in a 3 year follow up study of 35 peripheral facial paralysis patients who underwent the F wave and ENoG tests within 21 days after onset. We evaluated the correlation between clinical outcomes and early electrophysiological findings, the accuracy and sensitivity of F waves and ENoG in prognositic diagnosis and complication's prediction. F wave present or not and ENoG>90% are using to be the diagnostic boundary in two different tests.RESULTS: The accuracy of F wave in outcome prognosis was 97.1%, and higher than 88.6% by ENoG. The accuracy of the F wave in complication prognosis was 94.3%, and higher than 85.7% by ENoG. F wave can be used as a prognostic test in the early stage of the peripheral facial paralysis. The present of the F wave reflect the relative normal action conduct pathway and can be used as a signal of the good prognosis. F wave can be used to judge whether the patients need the surgery. Conserved treatment was verified to be effective on the patients whose F wave was present. By our results, if F wave was absent, the patient usually had a bad prognosis and the decompression surgery may be need to improve the outcome and prevent the complication. CONCLUSIONS: F waves represent a highly accurate pronostiic test in the early stage of the facial paralysis.Part 2 bFGF target muscle injection on the effect of the atrophy prevention in the facial nerve transected rabbits.OBJECTIVE: Facial muscle atrophy is a sequela in some patients with peripheral facial paralysis. The aim of this report is to assess the prevention usefulness of bFGF in the deinnervation facial muscles. METHODS: Vertical segments of the left facial nerve were cut in 25 New Zealand White rabbits, Random assignment was used after surgery, The other 4 rabbits were allocated into normal group. bFGF was injected into the left nasal labial elevator muscleimmediately after surgery in 12 animals, The other animals were allocated into 3 control groups. The test results were evaluated in 30, 60 and 90 days after nerve transection. Several morphologic methods including grossly inspect, wet weight of the muscle, HE histology and computer imaging analysis were used to investigate the muscle atrophy and whether bFGF can prevent the atrophy. RESULTS: In the control groups, facial muscle atrophy was induced by surgery within 90 days after transection. The wet weight of the muscle decreased rapidly in the first 30 days and down to 66% of the normal side, and it was 52% in 90 days. The normal myofiber decreased in 30 days and disappeared in 60 days after transection. These were instead of by the small and angulated atrophied myofibers and a few round hypertrophied myofibers with central migration of the nuclei. No compensation was found in 90 days after transection. In the bFGF groups, the muscle showed slight atrophy and no significant different were found in wet weight, area, diameter of the myofiber between the bFGF groups and normal group. The normal and hypertrophied myofibers were majority in the fascicles within 90 days and sandwiched by a few atrophic myofibers. We found 2 animals in bFGF groups had the facial nerve regeneration in vertical segment 90 days after transection. We estimated that bFGF could protect the deinnervation muscles and injured axons, and might be absorbed and transport antidromic to the nerve defect by remaining axons and improve the regeneration of the nerve. CONCLUSIONS: Facialmuscle atrophy can be induced by deinnervation, and it is a rapid progress within 90 days after the transection. Atrophy was partly prevented by bFGF target muscle injection. bFGF may have a very important clinical usefulness.Part 3 Laser Doppler Flowmetry using in the measurement of facial nerve blood flow in rabbitsOBJECTIVE: To study the microcirculation of the facial nerve in rabbits. METHODS: Laser Doppler Flowmetry was used in the blood flow measurement of the horizontal segment of the facial nerve and other adjacent structures in 28 New Zealand White rabbits. The repeated test was used to evaluate the stability of LDF. Several surgical manipulations on facial nerve were imitated on the second genu to find whether it can change the blood flow of the horizontal segment of the facial nerve. RESULTS: We established an animal model to study the microcirculation of the facial nerve in rabbits. The record of repeat test showed that LDF is a stable method. LDF of the horizontal segment of the facial nerve is higher in the proximal end and lower distal. LDF of the facial nerve is higher than the semicircle canal, medial wall of the attic, tendon of the tensor tympani muscle and other adjacent structures, p<0.05. LDF probe may become a detector of surgeon to find the facial nerve in the complicated operation fields and prevent the iatrogenic facial paralysis. Press on the nerve can induce the decrease of theLDF, we estimate LDF may be very useful in the study of facial nerve entrapment. Transection of the second genu can deceased 50% blood flow of the horizontal segment of the facial nerve. Using Adrenaline to control the nerve bleeding may induce the ischemia of the facial nerve and it should be used cautiously. CONCLUSIONS: LDF is a new, stable, objective method for microcirculation study on facial nerve, and very useful in pathophysiological investigation of peripheral facial paralysis.
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