顔面神経麻痺の電気生理学的検査法の再検討—何が最良なのか？

Re-evaluation of Electrophysiological Examinations for Facial Palsy

I．はじめに

　顔面神経麻痺に対する検査の目的は，障害部位診断，予後診断，麻痺経過の把握などが挙げられる。この中で実地医家にとって最も関心の高いものは予後早期診断であろう。

　表1は麻痺の予後判定のための検査法を一括したものである。

　There are so many electrophysiological examinations of evaluating the prognosis of facial palsy, and a consensus has not yet been obtained on the problems of which one is more useful than the others for general otolaryngologists. Our opinion is as follows:

　1. Electromyogram (EMG) is not important as an office test, because neurodegenerative findings cannot be estimated in the absence of fibrillation potentials on EMG.

　2. Although a stapedial reflex test is simple enough even for young children, and its early diagnostic value is also manifested, the evaluation of the prognosis by this test alone is unreliable.

　3. NET, MST, evoked EMG and ENoG all have extremely high reliability, but the reliability is not 100% for sure in any of them. It is therefore necessary for the better evaluation of the prognosis to combine two or more tests.

　4. Taking the reliability of evaluation of the prognosis and the simplicity of the test into consideration, ENoG combined with NET or evoked EMG is considered to be useful as an office test.