Neurootological findings in patients with facial nerve palsies
Abstract
The facial nerve carries a very sensitive neurosensorial, as well as sensory motor structure in very neighbourhood of the statoacoustic nerve. In this paper we are comparing related functional changes in the statoacoustic system in 2 samples with 235 cases of peripheral facial nerve palsies and 42 cases of central facial nerve palsies. When submitting both groups of cases to our neurootological history scheme NODEC III, we found an index of subjective vertigo complaints of 1,49% in peripheral versus 0,19% in central group. The indexes for nausea however show 0,53% peripheral level, and 0,62% for central. This shows that the peripheral cases relatively suffer more than the central cases. Double vision however occurs in 5,96% in peripheral and in 14,29% in central cases. With respect to subjective hearing complaints we see tinnitus in 37,30% in peripheral and 42,86% in central cases. Hearing loss nearly has the same incidence rate with 48,51% in peripheral and 47,62% in central. However the complete deafness amounts to 17,87% in peripheral and 7,14% in central. The high incidence in the peripheral group is due to a high amount of temporal bone fractures. The additional rate of disturbances in taste is higher in the central group and this also holds the trigeminal disturbances.
In both the groups much of spontaneous nystagmus is found by the polygraphic ENG in the sitting as well as in the lying position. By means of the Claussen butterfly calorigram we can detect 68,2% pathology in the peripheral facial group and only 64,8% in the central group. The VESRIC unveils in peripheral facial group 73,7% pathology and in the central only 67,5%. Especially the VESRIC discriminates between peripheral and central vestibular disturbances. The stepping test CCG is lagging behind the ENG. In peripheral facial nerve it only detects 58,7% pathology and in the central only 50,0%. The complaints about disturbances in hearing function are conformed in both groups in a similar amounts in speech audiometry as well as in pure tone audiometry.