• Journal of Acupuncture Research
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• v.19 no.5
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• pp.234-246
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• 2002

Background: Herpes Zoster Oticus, which can be caused from infection by Varicella-zoster virus, is known to be expected poor prognosis, since it has higher possibility of complete injury of facial nerve. Conservative therapy of the Western medicine is effective on the treatment for the herpes zoster and pain. However, its effectiveness on the facial verve palsy has not been proven. Objective : This study was performed to evaluate the treatment of oriental medicine and an analyze prognosis of the facial nerve palsy in Herpes Zoster Oticus. Methods : This retrospctive study was conducted to observe the clinical manifestation of Herpes Zoster Oticus, and the result of electrical diagnostic study on the patients with the facial nerve palsy in Herpes Zoster Oticus who were diagnosed and treated at the Department of Acupuncture & Moxibustion in Kyung Hee Oriental Medical Hospital. Results : 1. According to the six clinical types of Herpes Zoster Oticus, the patients in this study can be grouped as 7 cases of the type II, 2 cases of the type V, and one case of the type IV and the type VI. 2. The shorter the period from onset to the first visit to a hospital, the prognosis of facial nerve palsy in Herpes Zoster Oticus was the better. 3. According to the follow up study, the H-B grades of all cases were improved. 4. According to the follow up study, the result of electrical diagnostic study was improved. Conclusions : We found in our study that the treatment of oriental medicine, such as acupuncture, herbal medicine and aroma therapy, helps the recovery of facial nerve palsy in Herpes Zoster Oticus. The further clinical study about the more cases of facial nerve palsy in Herpes Zoster Oticus and comparative study between the group of oriental medicine and that of western medicine are needed.

• Clinical and Experimental Pediatrics
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• v.50 no.3
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• pp.272-276
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• 2007

Purpose : Bell's palsy is defined as an idiopathic facial nerve paralysis of sudden onset. In spite of intensive clinical and experimental investigation, there is still uncertainty in the incidence, etiology, and preferred mode of treatment in children. The objective of this study was to analyze clinical outcome and prognosis of children with Bell' palsy. Methods : We analyzed 61 cases of Bell's palsy diagnosed at the Department of Wonkwang University Hospital from January 1998 to July 2006. The inclusion criteria were any children with acute isolated unilateral lower motor neuron type of facial nerve palsy. The clinical findings and investigations were reviewed including age, sex, affected site, seasonal incidence and result of steroid treatment. Chi-square and Fisher's exact test was used to compare clinical outcome between duration of complete recovery and age. Results : There was no difference in incidence according to sex or age. Incidence was higher in summer and winter. There was no difference in complete recovery rate and duration between steroid treated group and control group. In the group of children younger than 6 years, duration of complete recovery was shorter than older children. Conclusion : We found increasing the incidence of Bell's palsy in summer and winter. Children younger than 6 years had shorter duration in complete recovery.

• Journal of Oral Medicine and Pain
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• v.38 no.3
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• pp.255-260
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• 2013

Bilateral sagittal split ramus osteotomy(BSSRO) of the mandible is an essential and commonly used procedure to correct dentofacial deformities and malocclusion. The possible complications associated with BSSRO include inferior alveolar nerve injury, bleeding, temporomandibular disorder, unfavorable fractures, and clinical relapse. The incidence of facial nerve palsy after orthognathic surgery recently reported is 0.1%. The probable etiologies have included facial nerve compression, complete or incomplete nerve transection, nerve traction, and nerve ischemia from anesthetic injection. Postoperative facial palsy is one of the most serious complications because it reduces the quality of life and significantly reduces social interaction. The case of a 24-year-old patient who underwent bilateral sagittal split ramus osteotomy is described. The medical records and postoperative photographs were reviewed in detail to collect information on the clinical course, treatment, and outcomes.

• Archives of Plastic Surgery
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• v.48 no.3
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• pp.278-281
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• 2021

Facial palsy (FP) is a functional disorder of the facial nerve involving paralysis of the mimic muscles. According to the principle "time is muscle," early surgical treatment is tremendously important for preserving the mimic musculature if there are no signs of nerve function recovery. In a 49-year-old female patient, even 19 months after onset of FP, successful neurotization was still possible by a V-to-VII nerve transfer and cross-face nerve grafting. Our patient suffered from complete FP after vestibular schwannoma surgery. With continuous application of electrostimulation (ES) therapy, the patient was able to bridge the period between the first onset of FP and neurotization surgery. The significance of ES for mimic musculature preservation in FP patients has not yet been fully clarified. More attention should be paid to this form of therapy in order to preserve the facial musculature, and its benefits should be evaluated in further prospective clinical studies.

• Archives of Craniofacial Surgery
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• v.22 no.6
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• pp.303-309
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• 2021

Background: Transferring the hypoglossal nerve to the facial nerve using an end-to-end method is very effective for improving facial motor function. However, this technique may result in hemitongue atrophy. The ansa cervicalis, which arises from the cervical plexus, is also used for facial reanimation. We retrospectively reviewed cases where facial reanimation was performed using the ansa cervicalis to overcome the shortcomings of existing techniques of hypoglossal nerve transfer. Methods: The records of 15 patients who underwent hypoglossal nerve transfer were retrospectively reviewed. Three methods were used: facial reanimation with hypoglossal nerve transfer (group 1), facial nerve reanimation using the ansa cervicalis (group 2), and sural nerve interposition grafting between the hypoglossal nerve and facial nerve (group 3). In group 1, the ansa cervicalis was coapted to neurotize the distal stump of the hypoglossal nerve in a subset of patients. Clinical outcomes were evaluated using the House-Brackmann (H-B) grading system and Emotrics software. Results: All patients in group 1 (n= 4) achieved H-B grade IV facial function and showed improvements in the oral commissure angle at rest (preoperative vs. postoperative difference, 6.48° ± 0.77°) and while smiling (13.88° ± 2.00°). In groups 2 and 3, the oral commissure angle slightly improved at rest (group 2: 0.95° ± 0.53°, group 3: 1.35° ± 1.02°) and while smiling (group 2: 2.06° ± 0.67°, group 3: 1.23° ± 0.56°). In group 1, reduced tongue morbidity was found in patients who underwent ansa cervicalis transfer. Conclusion: Facial reanimation with hypoglossal nerve transfer, in combination with hypoglossal nerve neurotization using the ansa cervicalis for complete facial palsy patients, might enable favorable facial reanimation outcomes and reduce tongue morbidity. Facial reanimation using the ansa cervicalis or sural nerve for incomplete facial palsy patients did not lead to remarkable improvements, but it warrants further investigation.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.336-341
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• 2007

Purpose: The most accepted method for the reanimation of a paralyzed face is the two-stage method that combines cross-face nerve grafting with free-muscle transfer. Although the results of reconstruction with this method are satisfactory, there is an excessive delay between the stages, which prolongs the period of rehabilitation. In order to overcome this drawback, a one- stage, neurovascular free-flap reconstruction method using free neurovascular muscle flaps is introduced. Methods: From 1994 to 2004, 35 patients with longstanding facial palsy were treated. Fifteen patients underwent the single-stage reconstruction with the latissimus dorsi muscle, and 20 patients underwent the two-stage reconstruction method with the gracilis muscle. We compared the long-term results of the two methods of reconstruction. The mean follow-up period was 28.7 months for one-stage reconstruction, and 35.2 months for the two-stage, respectively. Results: In the patient group of the single stage reconstruction, both mouth corner excursion and animation grade were markedly improved at the final postoperative visit. Moreover, the first muscle contraction occurred earlier in this group, than in the two-stage reconstruction group. However, four patients in the single stage group never achieved a first muscle contraction or mouth corner excursion. Conclusion: Facial palsy is a very challenging condition for cosmetic surgeons to deal with. Traditional methods for treatment of chronic facial palsy use a two-stage muscle flap which is time-consuming and burdensome to patients, many of whom are averse to waiting 8 to 12 months to complete the two stages. The one-stage reconstruction method described herein uses a latissimus dorsi free-flap and has demonstrated consistent positive outcomes in clinical assessments.

• Journal of Acupuncture Research
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• v.23 no.6
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• pp.229-238
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• 2006

Background and Objetive : The aim of this study is to report 3 cases of facial palsy following microvascular decompression in hemifacial spasm patients. It is a rare disease, with few research on the effect of acupuncture therapy on it. Material and Method : We selected 3 cases of facial palsy following microvascular decompression in hemifacial spasm patients, among patients who visited the Facial palsy Clinic of Kyunghee Oriental Medical Center. We treated them with acupuncture therapy(ST6, ST4, BL2, TE17, GV24, GV14, and Ex-HN4 of the healthy side, and LI4 and ST36 of both sides) and aroma therapy. After treatment we observed and checked any changes within clinical symptoms using the House-Brackmann Grade and the Yanagihara's Unweighted Grading System. Result and Conclusion : 1. All three cases were of hemifacial spasm patients who had facial palsy following microvascular decompression. The patients visited 27 months(Case1), 2 months(Case2) and 7 months(Case 3) after the surgery respectively. 2. Period of time till complete recovery is 23 months(Case1), 8 months(Case2) and 3 month (Case3) respectively. 3. All three cases had symptoms of sequelae: retraction of mouth toward the healthy side and involuntary spasm of lips. The later the initiation of treatment after the sugery, the more severe symptoms of sequelae.

• Journal of Audiology & Otology
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• v.23 no.1
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• pp.53-58
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• 2019

Background and Objectives: The aim of the present study was to assess the feasibility of a PC-based facial asymmetry assessment program (PC-FAAP) and to compare the results of PC-FAAP with subjective regional scoring by raters in acute unilateral peripheral facial nerve paralysis (FNP). Subjects and Methods: Participants were divided into 3 groups with 8 participants per group: group I, normal; group II, mild to moderate FNP; and group III, severe FNP. Using the PC-FAAP, the mouth asymmetry ratio (MAR), eyebrow asymmetry ratio (EAR), and complete eye closure asymmetry ratio (CAR) were calculated by comparing the movement of tracking points on both sides. The FNP grading scale (FGS) integrated each score, and the scores were weighted with a ratio of 5:3:2 (MAR:CAR:EAR). Subjective regional scoring was measured on a 0-100 scale score by three otologists. PC-FAAP and subjective scoring were compared in each group regarding the consistency of the results. Results: The mean scores of the MAR, EAR, CAR, and FGS of each group were significantly different. PC-FAAP showed significant differences between the three groups in terms of MAR, EAC, CAR, and FGS. PC-FAAP showed more consistent results than subjective assessment (p<0.001). The PC-FAAP was significantly more consistent in group I and group III (p<0.001 and p=0.002, respectively). FGS in group III was the only parameter that showed a more consistent result in PC-FAAP than the subjective scoring (p=0.008). Conclusions: An FNP grading system using a PC-based program may provide more consistent results, especially for severe forms.

• Korean Journal of Audiology
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• v.23 no.1
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• pp.53-58
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• 2019

Background and Objectives: The aim of the present study was to assess the feasibility of a PC-based facial asymmetry assessment program (PC-FAAP) and to compare the results of PC-FAAP with subjective regional scoring by raters in acute unilateral peripheral facial nerve paralysis (FNP). Subjects and Methods: Participants were divided into 3 groups with 8 participants per group: group I, normal; group II, mild to moderate FNP; and group III, severe FNP. Using the PC-FAAP, the mouth asymmetry ratio (MAR), eyebrow asymmetry ratio (EAR), and complete eye closure asymmetry ratio (CAR) were calculated by comparing the movement of tracking points on both sides. The FNP grading scale (FGS) integrated each score, and the scores were weighted with a ratio of 5:3:2 (MAR:CAR:EAR). Subjective regional scoring was measured on a 0-100 scale score by three otologists. PC-FAAP and subjective scoring were compared in each group regarding the consistency of the results. Results: The mean scores of the MAR, EAR, CAR, and FGS of each group were significantly different. PC-FAAP showed significant differences between the three groups in terms of MAR, EAC, CAR, and FGS. PC-FAAP showed more consistent results than subjective assessment (p<0.001). The PC-FAAP was significantly more consistent in group I and group III (p<0.001 and p=0.002, respectively). FGS in group III was the only parameter that showed a more consistent result in PC-FAAP than the subjective scoring (p=0.008). Conclusions: An FNP grading system using a PC-based program may provide more consistent results, especially for severe forms.

• Journal of Korean Neurosurgical Society
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• v.44 no.5
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• pp.285-294
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• 2008

Objective: Jugular foramen schwannomas are uncommon pathological conditions. This article is constituted for screening these tumors in a wide perspective. Materials: One-hundred-and-ninty-nine patients published in 19 articles between 1984 to 2007 years was collected from Medline/Index Medicus. Results: The series consist of 83 male and 98 female. The mean age of 199 operated patients was 40.4 years. The lesion located on the right side in 32 patients and on the left side in 60 patients. The most common presenting clinical symptoms were hearing loss, tinnitus, disphagia, ataxia, and hoarseness. Complete tumor removal was achieved in 159 patients. In fourteen patients tumor reappeared unexpectedly. The tumor was thought to originate from the glossopharyngeal nerve in forty seven cases; vagal nerve in twenty six cases; and cranial accessory nerve in eleven cases. The most common postoperative complications were lower cranial nerve palsy and facial nerve palsy. Cerebrospinal fluid leakage, meningitis, aspiration pneumonia and mastoiditis were seen as other complications. Conclusion: This review shows that jugular foramen schwannomas still have prominently high morbidity and those complications caused by postoperative lower cranial nerve injury are life threat.