Abstract：
This longitudinal study aims at assessing the predictive value of facial nerve high-resolution ultrasound (HRUS) for incomplete clinical recovery in patients with Bell\'s palsy, the most common facial nerve disease.
We prospectively enrolled 34 consecutive patients with Bell\'s palsy. All patients underwent neurophysiological testing (including facial nerve conduction study) and HRUS evaluations 10-15 days (T1), one month (T2), and three months (T3) after the onset of Bell\'s palsy. Patients who did not experience complete recovery within three months were also evaluated after six months (T4). We have then compared the accuracy of HRUS with that of the facial nerve conduction study in predicting incomplete clinical recovery at three and six months.
At T1, the facial nerve diameter, as assessed with HRUS, was larger on the affected side than on the normal side, particularly in patients with incomplete recovery at T2, T3 and T4. ROC curve analysis, however, showed that the facial nerve diameter at T1 had a lower predictive value than the facial nerve conduction study for an incomplete clinical recovery at three (T3) and six (T4) months. Still, the facial nerve diameter asymmetry, as assessed with HRUS, had a relatively high negative predictive value (thus indicating a strong association between normal HRUS examination and a good prognosis).
Although HRUS shows abnormally increased facial nerve diameter in patients in the acute phase of Bell\'s palsy, the predictive value of this technique for incomplete clinical recovery at three and six months is lower than that of the nerve conduction study.
Nerve ultrasound has a low predictive value for incomplete clinical recovery in patients with Bell\'s Palsy.
We prospectively enrolled 34 consecutive patients with Bell\'s palsy. All patients underwent neurophysiological testing (including facial nerve conduction study) and HRUS evaluations 10-15 days (T1), one month (T2), and three months (T3) after the onset of Bell\'s palsy. Patients who did not experience complete recovery within three months were also evaluated after six months (T4). We have then compared the accuracy of HRUS with that of the facial nerve conduction study in predicting incomplete clinical recovery at three and six months.
At T1, the facial nerve diameter, as assessed with HRUS, was larger on the affected side than on the normal side, particularly in patients with incomplete recovery at T2, T3 and T4. ROC curve analysis, however, showed that the facial nerve diameter at T1 had a lower predictive value than the facial nerve conduction study for an incomplete clinical recovery at three (T3) and six (T4) months. Still, the facial nerve diameter asymmetry, as assessed with HRUS, had a relatively high negative predictive value (thus indicating a strong association between normal HRUS examination and a good prognosis).
Although HRUS shows abnormally increased facial nerve diameter in patients in the acute phase of Bell\'s palsy, the predictive value of this technique for incomplete clinical recovery at three and six months is lower than that of the nerve conduction study.
Nerve ultrasound has a low predictive value for incomplete clinical recovery in patients with Bell\'s Palsy.
摘要：
目的：这项纵向研究旨在评估面神经高分辨率超声（HRUS）对贝尔麻痹患者临床不完全康复的预测价值，最常见的面神经疾病。
方法：我们前瞻性招募了34例连续的贝尔麻痹患者。所有患者均接受神经生理学测试（包括面神经传导研究）和HRUS评估10-15天（T1），一个月（T2），贝尔氏麻痹发作后三个月（T3）。在三个月内没有完全康复的患者也在六个月(T4)后进行评估。然后，我们将HRUS的准确性与面神经传导研究的准确性进行了比较，以预测3个月和6个月的临床不完全康复。
结果：T1时，面神经直径，根据HRUS的评估，患侧比正常侧更大，特别是在T2，T3和T4时不完全恢复的患者。ROC曲线分析,然而,结果表明，对于3个月（T3）和6个月（T4）的不完全临床恢复，T1时的面神经直径比面神经传导研究的预测值低。尽管如此，面神经直径不对称，根据HRUS的评估，具有相对较高的阴性预测值（因此表明正常HRUS检查与良好预后之间有很强的关联）。
结论：尽管HRUS在贝尔麻痹急性期患者中显示出异常增加的面神经直径，该技术对3个月和6个月时不完全临床恢复的预测价值低于神经传导研究。
结论：神经超声对贝尔麻痹患者临床不完全康复的预测价值较低。
方法：我们前瞻性招募了34例连续的贝尔麻痹患者。所有患者均接受神经生理学测试（包括面神经传导研究）和HRUS评估10-15天（T1），一个月（T2），贝尔氏麻痹发作后三个月（T3）。在三个月内没有完全康复的患者也在六个月(T4)后进行评估。然后，我们将HRUS的准确性与面神经传导研究的准确性进行了比较，以预测3个月和6个月的临床不完全康复。
结果：T1时，面神经直径，根据HRUS的评估，患侧比正常侧更大，特别是在T2，T3和T4时不完全恢复的患者。ROC曲线分析,然而,结果表明，对于3个月（T3）和6个月（T4）的不完全临床恢复，T1时的面神经直径比面神经传导研究的预测值低。尽管如此，面神经直径不对称，根据HRUS的评估，具有相对较高的阴性预测值（因此表明正常HRUS检查与良好预后之间有很强的关联）。
结论：尽管HRUS在贝尔麻痹急性期患者中显示出异常增加的面神经直径，该技术对3个月和6个月时不完全临床恢复的预测价值低于神经传导研究。
结论：神经超声对贝尔麻痹患者临床不完全康复的预测价值较低。
