• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.636-643
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• 2000

Facial asymmetry is the most frequent disease in craniofacial deformities. And the primary causing area of that is mostly placing in mandible. That is to say, it is known that primarily, mandible grows excessively or deficiently, and other facial region involving maxilla undergoes compensatory growth secondarily, so asymmetric face develops. In facial asymmetry, the surgical correction of undergrowth is more difficult than that of overgrowth and the reason of it is the postoperative relapse caused by stress of surrounding soft tissues. It means the stress of surrounding soft tissues occurring after bone lengthening and reducing above stress is the same meaning with reducing postoperative relapse. Among various areas, mandibular ramus is the most difficult area to lengthen vertically and maintain its length. The reason of it is considered by many authors as the stress of surrounding pterygomasseteric sling which is enveloping lower border of mandible and interrupting elongation of ramal height. So we applied two different surgical procedures in which pterygomasseteric slings have different stress respectively to monkeys which have similar masticatory function and anatomy to human being and compared relapse by radiographic film and observed periodically the histochemical change of masseteric muscle fiber. So we could see the following results. The relapse was less in EVRO group in which we separated pterygomasseric sling in inferior border and didn't approximate muscle sling after vertical lengthening to minimize the stress of soft tissues than IVRO group in which we elongated ramal height preserving pterygomassetric sling. Of course, we could see a problem in EVRO group such as bone resorption in inferior border caused by uncovering the periosteum of inferior border. But we expect that such problem will be solved by developing periosteum substitutes for covering the exposed bone and minimizing the surgical trauma. In histochemical study of masseteric muscle fiber, the fiber constituents of EVRO group in which we minimized soft tissue stress was changed immediately after operation and maintained it for 1 year, whereas that of IVRO group in which we preserved soft tissue stress was changed in more portion after operation and recovered it by 1 year. By the histochemical results, we can see that the recovery of fiber constituents reflect the recovery of muscle stress and it is closely related with relapse phenomenon.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.4
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• pp.358-361
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• 2001

We had experienced a case of traumatic myositis ossificans arising in right masseter muscle, inferior to zygomatic arch occurred on 25 year old male. He had some trauma on the site one year ago and visited with complaint of mouth opening limitation and swelling. Palpable mass with facial disfigurement was noted. and several ovoid radiopaque masses were revealed on C.T. examination. On histopathologic examination, multiple bone trabeculae with osteoblasts in its periphery was noted in connective tissues and invaded to neighbouring muscles, but any chondroid components were not revealed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.4
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• pp.344-350
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• 2010

A progressive hemifacial atrophy is characterized by progressive atrophy of subcutaneous fat and rarely muscle and bone. Its contour follows the underlying muscle. Unilateral involvement is common. The treatment goal has been focused on the augmentation of the soft tissue. Many materials such as implants, collagen, fat graft, fat injection, dermal fat graft, filler and vascualized autogenous graft have been used. Although these materials have been used, the best treatment hasn't been achived. In severe cases underlying soft tissue, muscle and bone may be atrophied and massive soft tissue graft, implant and orthognathic surgery must be used. The author used the dermal-fat tissue for the pupose of soft tissue augmentation. We can get the massive soft tissue by the dermolipectomy procedure through the mini-abdominoplsty. The facial augmentation was done by augmentation of the dermal-fat tissue. The progressive hemifacial atrophy is hard to treat by only one procedure and many modalites must be considered.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.11 no.4
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• pp.2124-2148
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• 2017

Accurate facial expression recognition (FER) requires reliable signal filtering and the effective feature extraction. Considering these requirements, this paper presents a novel approach for FER which is robust to noise. The main contributions of this work are: First, to preserve texture details in facial expression images and remove image noise, we improved the anisotropic diffusion filter by adjusting the diffusion coefficient according to two factors, namely, the gray value difference between the object and the background and the gradient magnitude of object. The improved filter can effectively distinguish facial muscle deformation and facial noise in face images. Second, to further improve robustness, we propose a new feature descriptor based on a combination of the Histogram of Oriented Gradients with the Canny operator (Canny-HOG) which can represent the precise deformation of eyes, eyebrows and lips for FER. Third, Canny-HOG's block and cell sizes are adjusted to reduce feature dimensionality and make the classifier less prone to overfitting. Our method was tested on images from the JAFFE and CK databases. Experimental results in L-O-Sam-O and L-O-Sub-O modes demonstrated the effectiveness of the proposed method. Meanwhile, the recognition rate of this method is not significantly affected in the presence of Gaussian noise and salt-and-pepper noise conditions.

• Archives of Plastic Surgery
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• v.41 no.1
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• pp.50-56
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• 2014

Background The aim of this study was to determine the efficacy of lateral intercostal artery perforator-based adipofascial free flaps for facial reconstruction in patients with facial soft tissue deficiency. Methods We conducted a retrospective study of five consecutive patients diagnosed with facial soft tissue deficiency who underwent operations between July 2006 and November 2011. Flap design included the area containing the perforators. A linear incision was made along the rib, which had the main intercostal pedicle. First, we dissected below Scarpa's fascia as the dorsal limit of the flap. Then, the adipofascial flap was elevated from the medial to the lateral side, including the perforator that pierces the serratus anterior muscle after emerging from the lateral intercostal artery. After confirming the location of the perforator, pedicle dissection was performed dorsally. Results Dominant perforators were located on the sixth to eighth intercostal space, and more than four perforators were found in fresh-cadaver angiography. In the clinical case series, the seventh or eighth intercostal artery perforators were used for the free flaps. The mean diameter of the pedicle artery was 1.36 mm, and the mean pedicle length was 61.4 mm. There was one case of partial fat necrosis. No severe complications occurred. Conclusions This is the first study of facial contour reconstruction using lateral intercostal artery perforator-based adipofascial free flaps. The use of this type of flap was effective and can be considered a good alternative for restoring facial symmetry in patients with severe facial soft tissue deficiency.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.2
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• pp.215-219
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• 1999

This article discusses the diagnosis, anatomic consideration, and surgical management of masseter muscle hypertrophy. Surgical correction is advised for patients who have esthetic complaints. Esthetic improvement can be achieved by surgery and not by conservative treatment. Recently, the intraoral method, which leaves no scar on the face and minimizes the possibility of injury to the marginal branch of the facial nerve, has been supported by many surgeons. Patients who complained of marked swelling of unilateral or bilateral mandibular angle area and showed abnormal bony growth at the mandibular angle area and enlarged masseter muscle received mandibular angle shaving and excision of the inner layer of masseter muscle with intraoral approach. After operation, physiotherapy was done with EAST(eletrical acupuncture stimulation therapy) for encouraging the mouth opening and reducing the swelling. They showed early maximum mouth opening and reduction of swelling.

• Anatomy and Cell Biology
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• v.56 no.3
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• pp.293-298
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• 2023

The mentalis muscle is a paired muscle originating from the alveolar bone of the mandible. This muscle is the main target muscle for botulinum neurotoxin (BoNT) injection therapy, which aims to treat cobblestone chin caused by mentalis hyperactivity. However, a lack of knowledge on the anatomy of the mentalis muscle and the properties of BoNT can lead to side effects, such as mouth closure insufficiency and smile asymmetry due to ptosis of the lower lip after BoNT injection procedures. Therefore, we have reviewed the anatomical properties associated with BoNT injection into the mentalis muscle. An up-to-date understanding of the localization of the BoNT injection point according to mandibular anatomy leads to better injection localization into the mentalis muscle. Optimal injection sites have been provided for the mentalis muscle and a proper injection technique has been described. We have suggested optimal injection sites based on the external anatomical landmarks of the mandible. The aim of these guidelines is to maximize the effects of BoNT therapy by minimizing the deleterious effects, which can be very useful in clinical settings.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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• pp.785-796
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• 2019

Objective: Facial nerve palsy causes both facial muscle malfunction and mental illness. Because a facial nerve palsy lesion shows on the face, it can have serious effects on social relationships and mental health. Many facial nerve palsy patients undergo anxiety, depression, and social phobia. In this study, a facial nerve palsy patient with sleep disorder was admitted to the Korean medicine hospital for treatment. Methods: The patient with facial nerve palsy and sleep disorder was treated with herbal medicines, acupuncture, herbal acupuncture therapy, and physical therapy. We used the House Brackmann grading system and Yanagihara's Unweighted Grading System to assess changes in facial nerve palsy symptoms and the Korean Modified Leeds Sleep Evaluation Questionnaire to assess the sleep disorder. Results: The patient was hospitalized for 18 days and showed a recovery from both facial nerve palsy and sleep disorder symptoms without any adverse events. We conclude that patients with facial nerve palsy should be treated from both the physical and mental health perspectives.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.4
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• pp.380-383
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• 2006

Tetanus is rare in Korea due to the introduction of vaccination programs and the advancement in public health. Its common signs are trismus, voice disturbance, neck stiffness, and difficulty in swallowing, etc. A 56 years old man was injured by grasping a high voltage electric cable. After the accident, he fell down on a steel plate and had a head trauma. When he visited Emergency Department, there was multiple electric burn wound on left arm and left facial area. He was hospitalized on a department of neurosurgery, because intra cranial hemorrhage was presumed. 12 days later, he was referred to department of OMFS with developed painful masseter spasms and trismus. That night he violently bit his tongue with his denture. Because masseter muscle and temporal muscle constriction was involuntary, tongue was lacerated and denture was distorted. At first we supposed that the symptom was related with neurologic disturbance following head trauma or electric shock. But it was revealed that trismus was caused by tetanus on an electrophysiological test. By using mechanical ventilation and administration of tetanus immunoglobulin, muscle-relaxant, and sedatives at ICU, symptoms had subsided (4-weeks). Because tetanus is rare disease, we rarely suppose tetanus infection to be a cause of a trismus. Especially it is more difficult to diagnose in patient who has head trauma, burn and neurologic problem as in this case.

• Journal of Acupuncture Research
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• v.39 no.4
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• pp.297-303
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• 2022

Background: This retrospective study aimed to determine whether there were correlations between the number and type of accompanying symptoms of peripheral facial nerve palsy, and surface electromyography (SEMG) and clinical assessment scales to help diagnosis. Methods: There were 30, cases of peripheral facial nerve palsy at Visit 1 to the Korean Medicine Hospital, Dong-eui University, 22 cases at Visit 2 and 10 cases at Visit 3. The study period was from July 19, 2021 to November 31, 2021. Symptoms were evaluated three times (with two-week intervals which began 7 days from onset) using SEMG, clinical assessment scales and accompanying symptoms. In this study, the House-Brackmann grading system (HBGS), and the Yanagihara's unweighted grading system (Y-score) clinical assessment scales were used. The Pearson or Spearman correlation was used for statistical analysis. Results: On Visit 1, the number of accompanying symptoms of peripheral facial nerve palsy had no significant correlation with other measures. On Visits 1-3, the HBGS score had a significant negative correlation with the Y-score. On Visit 2, most of the mean values measured had significant correlations with each other although not between SEMG-Z and SEMG-O that Z means a zygomaticus muscle and O means a orbicularis oris muscle. On Visit 3, the number of accompanying symptoms significantly correlated with the clinical assessment scales. The HBGS score, Y-score, and SEMG measurements (except SEMG-Z) had significant correlations with each other. A significant positive correlation between SEMG-Z and SEMG-T was noted. Conclusion: We predict accompanying symptoms can be used to diagnose the peripheral facial nerve palsy including both clinical assessment scales and SEMG measurements at 2-5 weeks after onset.