Analysis Of The Characteristics Of Vestibular Function Examination In Peripheral Facial Paralysis

【Background】Facial paralysis is one of the common signs of cranial nerve diseases.Bounded by the facial nerve nucleus,facial paralysis caused by upper motor pathway dysfunction is defined as central facial paralysis,and the main sign is lower hemifacial paralysis(below the eye fissure)of the lesion;while facial paralysis caused by subnuclear motor pathway dysfunction is defined as peripheral facial paralysis,which is characterized by ipsilateral global paralysis.In addition to the symptoms of facial paralysis,patients with peripheral facial paralysis may also have other manifestations,such as peripheral ear pain,impaired hearing,facial paraesthesia and even vertigo.Some scholars have found that the impaired vestibular nerve and / or labyrinth are associated with dizziness in patients with facial paralysis.Vestibular system anatomy and nerve course are very complex and often require the help of advanced vestibular function examination techniques to assist in diagnosis and treatment.With the development of vestibular function examination,vestibular evoked myogenic potentials(VEMPs)have gradually become a hot spot in recent years by virtue of their objective and objective operation methods,which mainly reflect the integrity of the vestibulo-brainstem pathway and are important for the auxiliary diagnosis and classification of vestibular related diseases and compensating for the shortcomings of temperature tests in the diagnosis of subvestibular nerve diseases.At present,there are still few studies on patients with facial paralysis combined with vestibular dysfunction at home and abroad,so further studies are needed.【Objective】Through the technique of vestibular function examination,the characteristics and regularity of VEMPs in patients with peripheral facial paralysis,central facial paralysis,and peripheral vestibular dysfunction represented by vestibular neuritis were studied,and the diagnostic value of VEMPs in peripheral facial paralysis was discussed.【Subjects and method】Eighty-seven patients with peripheral facial paralysis were selected as the study group,and patients with central facial paralysis(47 cases),vestibular neuritis(34 cases)and normal control group(49 cases)were selected as the control group for VEMPs examination.The various data of VEMPs results in these four groups were compared.VNG examination was also performed in each group to analyze the abnormal rate of VNG between the groups.Combining the above analysis results,the relationship between the groups was compared.【Results】1.The abnormal rates of c VEMP,o VEMP and VEMPs in peripheral facial paralysis were not significantly different from those in central facial paralysis vestibular neuritis group(P> 0.05),and the abnormal rates in peripheral facial paralysis and normal control group were statistically different(P < 0.05);further comparison of the abnormal rates of c VEMP and o VEMP on the affected side showed that there was a statistically significant difference in the abnormal rates of vestibular neuritis and o VEMP in peripheral facial paralysis(P< 0.05).2.In the analysis of the specific values of c VEMP and o VEMP,it could be found that the amplitude of peripheral facial paralysis group and normal control group of vestibular neuritis was significantly reduced,while the asymmetry ratio was significantly increased(P< 0.05);and in the comparison with the healthy side,it was also found that the amplitude of peripheral facial paralysis and vestibular neuritis was also significantly reduced compared with the healthy side.3.In the comparison of abnormal rate of VNG,the abnormal rate of smooth tracking,saccade and visual nystagmus in patients with central facial paralysis was significantly higher than that in the other three groups(P< 0.05);the abnormal rate of temperature test in peripheral facial paralysis group was significantly lower than that in vestibular neuritis group,but there was significant statistical difference compared with central facial paralysis and normal control group(P < 0.05);15 patients(17.2%)with peripheral facial paralysis had spontaneous nystagmus,and the positive rate was higher than that in central facial paralysis(4.3%)and normal control group(0),and lower than that in vestibular neuritis group(100%).【Conclusions】The abnormal rate of VEMPs was increased and the amplitude was decreased in patients with peripheral facial paralysis,and VEMPs have some value in the assessment of objective vestibular function in patients with peripheral facial paralysis.VEMPs combined with VNG examinations such as saccade test,smooth tracking test,and visual nystagmus can provide a basis for judging the presence of central vestibular pathway lesions in patients with central facial paralysis.Further studies are needed to evaluate the degree of vestibular nerve damage and prognosis in patients with peripheral facial paralysis using vestibular function tests.