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The Facial Nerve
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Christopher Skilbeck, Samuel MacKeith
During electroneuronography (ENoG), a supramaximal stimulus is delivered to the facial nerve trunk as it exits the stylomastoid foramen and the evoked biphasic compound muscle action potential (CMAP) is recorded using surface electrodes. The response of the paralysed side is expressed as a percentage of the normal contralateral side. If the CMAP amplitude on the affected side is 10% of the normal side, then it is assumed that 90% axonal loss has been sustained. ENoG is said not to be useful until the fourth day of facial nerve paralysis, which is when axonal degeneration associated with injury occurs.
Facial nerve—a clinical and anatomical review
Published in J. Belinha, R.M. Natal Jorge, J.C. Reis Campos, Mário A.P. Vaz, João Manuel, R.S. Tavares, Biodental Engineering V, 2019
Fernand Gentil, J.C. Reis Campos, Marco Parente, C.F. Santos, Bruno Areias, R.M. Natal Jorge
The electroneuronography technique was referred to for the first time in 1973 by Esslen, keeping your utility and still today (Esslen 1977). The principle is based on the evaluation of the latency and amplitude of nerve conduction using skin electrodes. It is an objective electrophysiological technique, which records a compound muscle action potential, by stimulation of the facial nerve and that allows for comparison with the normal side, knowing the percentage of injured fibers of the the paralyzed side. The prognosis depends on the percentage of the injured fibers. The electroneuronographic study should be done two to three days after the paralysis and repeated periodically until about the 12th day after the onset of paralysis for a better prognosis. Nerve wallerian degeneration completed in eight to ten days, it is in this period that can predict the percentage of fibers that remain and which would degenerate sequels, makes no sense to repeat the test after the 14th day after the initiation the injury.
Acute facial palsy
Published in S. Musheer Hussain, Paul White, Kim W Ah-See, Patrick Spielmann, Mary-Louise Montague, ENT Head & Neck Emergencies, 2018
Richard M Irving, Raghu Nandhan Sampath Kumar
Although not indicated in the acute setting, it is essential for the clinician to understand objective electrophysiological tests that help evaluate the degree of facial nerve dysfunction/potential recovery and can guide ongoing management – in particular, timing of surgical decompression and facial reanimation procedures. Currently, the two most common neurophysiology tests used are electroneuronography (ENoG) and electromyography (EMG).
Comparison of the efficacy of various doses of steroids for acute facial palsy
Published in Acta Oto-Laryngologica, 2019
Kuk Jin Nam, Mun Soo Han, Yong Jun Jeong, YoonChan Rah, June Choi
We performed a retrospective chart review of all patients and compared the treatment regimen, facial rehabilitation, electroneuronography (ENoG) data, and the initial and 3-month follow-up (HB) grades. The patients were divided into three groups on the basis of the treatment protocols as follows: the high-dose group receiving a total steroid dose equivalent to 634.7 mg of methylprednisolone (74 mg of intravenous [IV] dexamethasone and 240 mg of oral [PO] methylprednisolone, n = 15) for 12 days, the moderate-dose group receiving 496 mg of PO methylprednisolone for 12 days (n = 12), and the low-dose group receiving 344 mg of PO methylprednisolone for 10 days (n = 22). The detailed treatment regimen is shown in Table 1.