• Journal of Korean Neurosurgical Society
• /
• v.60 no.2
• /
• pp.165-173
• /
• 2017

Objective : To explore and analyze the influencing factors of facial nerve function retainment after microsurgery resection of acoustic neurinoma. Methods : Retrospective analysis of our hospital 105 acoustic neuroma cases from October, 2006 to January 2012, in the group all patients were treated with suboccipital sigmoid sinus approach to acoustic neuroma microsurgery resection. We adopted researching individual patient data, outpatient review and telephone followed up and the House-Brackmann grading system to evaluate and analyze the facial nerve function. Results : Among 105 patients in this study group, complete surgical resection rate was 80.9% (85/105), subtotal resection rate was 14.3% (15/105), and partial resection rate 4.8% (5/105). The rate of facial nerve retainment on neuroanatomy was 95.3% (100/105) and the mortality rate was 2.1% (2/105). Facial nerve function when the patient is discharged from the hospital, also known as immediate facial nerve function which was graded in House-Brackmann : excellent facial nerve function (House-Brackmann I-II level) cases accounted for 75.2% (79/105), facial nerve function III-IV level cases accounted for 22.9% (24/105), and V-VI cases accounted for 1.9% (2/105). Patients were followed up for more than one year, with excellent facial nerve function retention rate (H-B I-II level) was 74.4% (58/78). Conclusion : Acoustic neuroma patients after surgery, the long-term (${\geq}1year$) facial nerve function excellent retaining rate was closely related with surgical proficiency, post-operative immediate facial nerve function, diameter of tumor and whether to use electrophysiological monitoring techniques; while there was no significant correlation with the patient's age, surgical approach, whether to stripping the internal auditory canal, whether there was cystic degeneration, tumor recurrence, whether to merge with obstructive hydrocephalus and the length of the duration of symptoms.

• Journal of Korean Academy of Nursing
• /
• v.46 no.4
• /
• pp.542-551
• /
• 2016

Purpose: The purpose of this study was to examine the effects of a facial muscle exercise program including facial massage on the facial muscle function, subjective symptoms related to paralysis and depression in patients with facial palsy. Methods: This study was a quasi-experimental research with a non-equivalent control group non-synchronized design. Participants were 70 patients with facial palsy (experimental group 35, control group 35). For the experimental group, the facial muscular exercise program including facial massage was performed 20 minutes a day, 3 times a week for two weeks. Data were analyzed using descriptive statistics, ${\chi}^2$-test, Fisher's exact test and independent sample t-test with the SPSS 18.0 program. Results: Facial muscular function of the experimental group improved significantly compared to the control group. There was no significant difference in symptoms related to paralysis between the experimental group and control group. The level of depression in the experimental group was significantly lower than the control group. Conclusion: Results suggest that a facial muscle exercise program including facial massage is an effective nursing intervention to improve facial muscle function and decrease depression in patients with facial palsy.

• Archives of Craniofacial Surgery
• /
• v.18 no.1
• /
• pp.65-70
• /
• 2017

A 25-years-old woman with mandibular prognathism underwent a mandibular setback by way of mandibular sagittal split ramus osteotomy (MSSRO). After 2 days of operation, she developed difficulty of closing her right eye. The blink reflex test and motor nerve conduction study of the right orbicularis oris muscle were revealed right facial neuropathy of unknown origin and House-Brackmann facial nerve grading system (HBFNGS) grade V. For treatment, we initially prescribed oral prednisolone and nimodipine including physical therapy. The samples consisted of 11 facial nerve palsy patients caused by MSSRO and were analysed about onset of facial nerve palsy, postoperative HBFNGS, final HBFNGS, treatment method and recovery time. At 10 weeks of treatment of nimodipine, she had completely regained normal function (HBFNGS grade I) of the right facial nerve. The clinical results lead to assume a fast recovery of facial nerve function by the nimodipine medication, whereas average time of recovery is 16.32 weeks in references. Despite of the limited one patient treated, the result was very promising with respect to a faster recovery of the facial nerve function. Considering the use of nimodipine treatment for peripheral facial nerve palsy following a surgical approach with an anatomically preserved nerve can be recommended.

• Journal of Korean Neurosurgical Society
• /
• v.55 no.4
• /
• pp.208-211
• /
• 2014

Recently, the increasing rates of facial nerve preservation after vestibular schwannoma (VS) surgery have been achieved. However, the management of a partially or completely damaged facial nerve remains an important issue. The authors report a patient who was had a good recovery after a facial nerve reconstruction using fibrin glue-coated collagen fleece for a totally transected facial nerve during VS surgery. And, we verifed the anatomical preservation and functional outcome of the facial nerve with postoperative diffusion tensor (DT) imaging facial nerve tractography, electroneurography (ENoG) and House-Brackmann (HB) grade. DT imaging tractography at the 3rd postoperative day revealed preservation of facial nerve. And facial nerve degeneration ratio was 94.1% at 7th postoperative day ENoG. At postoperative 3 months and 1 year follow-up examination with DT imaging facial nerve tractography and ENoG, good results for facial nerve function were observed.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.24 no.3
• /
• pp.37-54
• /
• 2011

Background and Objective : Recently it is true that increasing interest in Oriental medicine and usage of herbal medicine. On the other hand, there are many concerns about the stability of herbal medicine. So, this study is carried out to see whether or not the treatment with Sanghan-Bang(傷寒方) is effective on the liver function besides its effectiveness in treating facial palsy. Methods : We examined serum TP, Albumin, TB, AST, ALT, ALP, LDH, ${\gamma}$-GGT levels, and facial palsy states in 37 patients with facial palsy who had admission treatment in an oriental medical hospital. Results and Conclusion : 1. We found the levels of TP, albumin, TB, and ${\gamma}$-GGT had decreased statistically significant. Also, AST, ALT, LDH and ALP levels had decreased however it was not statistically significant. 2. We analyzed the herbal group that may be efficient to the liver function; Daehwang-Jae(16 case), Injin-Jae(12 case), and Chija-Jae(6 case) in this order. 3. From the eight cases using oriental medicinal concoctions using one of Daehwang, Injin-Jae or Chija as their main component, the liver function test results displayed decreasing values, re-entering into normal LFT ranges. 4. As we compared the admission House-Brackmann Scale with discharge, the treatment was efficient and statistically significant.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.20 no.3
• /
• pp.147-160
• /
• 2007

Background and Objective : The facial nerve grading system proposed by House and Brackmann is most widely accepted for the clinical assessment of facial nerve injury. Because of the limitations and subjectivity of the House-Brackmann scale, several new scales of varying degrees of objectivity and ease of use have been introduced. To assess methods of evaluating the function of the facial nerve that have been introduced over the past 20 years, We compared with the House-Brackmann scale. Method : We referred to the information through Entrez Pubmed and Korean studies information(KSI) from 1985 to 2006 about methods of evaluating facial nerve function. We choose 7 scales that focused on objective and easy of use. Result and conclusion : Sunnybrook scale is a weighted, subjective scale with incorporation of secondary defects into a single composite score. Sunnybrook scale can be recommended over House-Brackmann scale.

• Therapeutic Science for Rehabilitation
• /
• v.11 no.1
• /
• pp.69-85
• /
• 2022

Objective : This study aimed to develop a Comprehensive Oro-Facial Function Scale (COFFS) that can evaluate oro-facial function in patients with dysphagia. Methods : To verify the item composition and reliability of the COFFS, preliminary items were collected by selecting and analyzing four previous studies, and the Content Validity Ratio (CVR) was derived through a second survey of experts. Cronbach's 𝛼 was calculated for the internal validity of the evaluation items, and the test-retest reliability and inter-rater reliability were calculated using the internal classification coefficients (ICC). Results : The content validity ratio of all items was 0.67; in the case of Cronbach's 𝛼 value for each domain, 0.849 for communication domain, -0.224 for the oro-facial structure and shape, 0.831 for the ability to perform orofacial movements, and 0.946 for mastication and swallowing function. The test-retest reliability was 0.974 and the inter-rater reliability was 0.937, showing high reliability. Conclusion : In this study, the evaluation tool of COFFS was finally selected from 34 items in four areas and developed on a 3-5 point scale according to the evaluation items. In future studies, additional research is needed to prove its validity through correlation with other evaluation tools that measure oro-facial function.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.42
• /
• pp.2.1-2.6
• /
• 2020

Background: Facial palsy treatment comprises static and dynamic techniques. Among dynamic techniques, local temporalis transposition represents a reliable solution to achieve facial reanimation. The present study describes a modification of the temporalis tendon transfer using a cryopreserved fascia allograft. Case presentation: Between March 2015 and September 2018, seven patients with facial palsy underwent facial reanimation with temporalis tendon transfer and fascia lata allograft. Patients with long-term palsy were considered, and both physical and social functions were evaluated. The mean follow-up time was 21.5 months. No immediate complications were observed. Patients reported improvement in facial symmetry both in static and dynamic. Improvement was noticed also in articulation, eating, drinking, and saliva control. The Facial Disability Index revealed an improvement both in physical function subscale and in the social/well-being function subscale. Conclusions: This modified orthodromic technique allows to reduce the operative time and the risk of complications connected to the use of autologous tissues. The use of the cryopreserved fascia allografts from cadaveric donors seems to provide promising and long-standing results in the treatment of facial palsy.

• Journal of Korean Neurosurgical Society
• /
• v.56 no.1
• /
• pp.11-15
• /
• 2014

Objective : Facial nerve palsy is a common complication of treatment for vestibular schwannoma (VS), so preserving facial nerve function is important. The preoperative visualization of the course of facial nerve in relation to VS could help prevent injury to the nerve during the surgery. In this study, we evaluate the accuracy of diffusion tensor tractography (DTT) for preoperative identification of facial nerve. Methods : We prospectively collected data from 11 patients with VS, who underwent preoperative DTT for facial nerve. Imaging results were correlated with intraoperative findings. Postoperative DTT was performed at postoperative 3 month. Facial nerve function was clinically evaluated according to the House-Brackmann (HB) facial nerve grading system. Results : Facial nerve courses on preoperative tractography were entirely correlated with intraoperative findings in all patients. Facial nerve was located on the anterior of the tumor surface in 5 cases, on anteroinferior in 3 cases, on anterosuperior in 2 cases, and on posteroinferior in 1 case. In postoperative facial nerve tractography, preservation of facial nerve was confirmed in all patients. No patient had severe facial paralysis at postoperative one year. Conclusion : This study shows that DTT for preoperative identification of facial nerve in VS surgery could be a very accurate and useful radiological method and could help to improve facial nerve preservation.

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