• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제26권6호
• /
• pp.677-680
• /
• 2000

Orbital injuries are common with facial trauma. Direct injuries to the globe are not rare but it can result in complications such as chemosis, subconjunctival hemorrhage and hyphema. Periorbital trauma or injuries to the extraocular muscles and blow-out fracture may result in lid edema, ecchymosis & ptosis and diplopia or limitation of ocular motion respectively. Indirect injuries to the optic nerve come up without any injuries but its complication is irreversible and severe such as loss of vision. The aim of this study is to review the literature on blindness or ptosis following facial trauma and present the cases of blindness after facial trauma and ptosis after mandibular fracture without specific clinical findings.

• Journal of Korean Neurosurgical Society
• /
• 제30권sup1호
• /
• pp.44-50
• /
• 2001

Objectives : The objective of this study was to investigate the role of postoperative three dimensional short-range magnetic resonance angiography(3D-TOF MRA) in predicting the clinical outcomes following microvascular decompression(MVD) for the treatment of a hemifacial spasm(HFS). Material and Method : Postoperative magnetic resonance(MR) imaging was performed on 123 patients with a HFS between March 1999 and May 2000. All patients who had postoperative MR imaging were undertaken preoperative MR imaging. Of the 123 patients, 122 patients were included in this retrospective study. The degree of the detachment of vascular contact, and change of the position of offender were determined by pre- and postoperative 3D-TOF MRA. These findings were compared with the surgical findings and clinical outcomes. Results : Of 122 patients who had successful MVD, clear decompression of offenders of the root entry zone(REZ) of facial nerve was found in 106 patients(86.9%), partial decompression in 10 patients(8.2%) and contact of offenders to the REZ of facial nerve in 6 patients(4.9%) by the postoperative 3D-TOF MRA. Our patients demonstrated that the types of offender did not influence with the degree of decompression of REZ of facial nerve and with surgical outcomes(p>0.05). Also, there was no significant relationship between the degree of decompression of the REZ of facial nerve from offenders and an improvement of symptoms(p>0.05). Futhermore, there was no significant relationship between the degree of decompression of the REZ of facial nerve from offenders and an improvement time (p>0.05). Conclusion : Our data suggests that MVD of facial nerve alone may not be sufficient to resolve the symptoms in all patients with hemifacial spasm. Therefore, another unknown factors besides vascular compression may be involved to cause symptoms in certain patients and it may be necessary to remove these factors with MVD simultaneously to obtain the resolution of symptom.

• 대한두개안면성형외과학회지
• /
• 제10권1호
• /
• pp.33-36
• /
• 2009

Purpose: Fractures of the mandibular condylar area are common injuries that account for 29% to 40% of fractures of the facial bones and represent 20% to 62% of all mandibular fractures. Currently 3 main methods are being used in the treatment of mandibular subcondylar fractures: closed reduction; open reduction and internal fixation; Endoscopic reduction and internal fixation. Each method has its proponents and opponent as well as advantages and disadvantages, and indications for each vary among surgeons. There are six approaches of open reduction: submandibular, retromandibular, preaurilcular, postauricular, intraoral, transparotid approach. Among them, transparotid approach has been described for subcondylar exposure with dissection in the direction of facial nerve fibers to expose the bone through the parotid gland. This approach carries the risk of a parotid glandular fistula as well as facial nerve injury but has the advantage of being directly over the fracture site. We report safety and efficacy of surgical treatment using a transparotid approach for direct plating. Methods: A 43-year-old man sustained multiple facial bone fractures by driver traffic accident. Mandibular subcondyle was fractured and dislocated internally. We performed open reduction and internal fixation by transparotid approach. Fractured site was fixed by titanium mini plate & screw. We applicated arch bar for approximately 3 weeks. Results: Follow-up length was about 5months. Scar of surgical incision was indistinct, there was no symptoms and signs of facial nerve and parotid gland injury, and maximal mouth opening was measured 49.5 mm. Conclusion: Transparotid approach has high risks of facial nerve and parotid gland injury, but paradoxically it is the most effective technique in saving facial nerve. Open reduction and internal fixation of mandibular subcondylar fracture by transparotid approach with precise and versed procedure, best outcome can be expected.

• Journal of Acupuncture Research
• /
• 제41권1호
• /
• pp.53-62
• /
• 2024

Background: The aim of this study is to determine the correlation between clinical assessment scales, self-assessment scales, and surface electromyography (SEMG) for facial nerve palsy. Methods: This study assessed 32 cases of facial nerve palsy on the first visit, 11 cases on the second visit, and 9 cases on the third visit to the Korean medicine hospital, university. This study was conducted from October 22, 2022, to December 22, 2022. The patients were evaluated using SEMG, clinical assessment scales, and self-assessment scales 3 times. The House-Brackmann grading systems (HBGS), Yanagihara unweighted grading system (Y-score), facial disability index, numerous rating scale, and accompanying symptoms of facial nerve palsy were used for assessment. Moreover, statistical correlation was analyzed using Pearson correlation. Results: On Visit 1, Significant correlations were observed between the results of SEMG and other clinical assessment scales as well as between SEMG-F (frontalis) and different parts of the Y-score. On Visit 2, significant correlations were observed between the results of SEMG and HBGS as well as between SEMG-F and the detailed parts of the Y-score. On Visit 3, significant correlations were observed only between SEMG-F and the detailed parts of the Y-score. A significant correlation was also observed between the changes in the clinical assessment scales on Visits 1 and 3 and between the changes in SEMG-F and those in the patient self-assessment scales. Conclusion: These findings suggest that SEMG can be used to evaluate facial nerve palsy in conjunction with the use of other clinical assessment scales.

• Annals of Clinical Neurophysiology
• /
• 제6권2호
• /
• pp.75-79
• /
• 2004

Backgrounds: Electrodiagnostic tests have been developed to estimate the degree of facial nerve injury during the acute phase. Side-to-side amplitude comparison with the affected side expressed as a percentage of the nonaffected side has been one of the most valuable electrophysiologic methods of assessing facial nerve functioning. This study was designed to know whether there is any difference in the side-to-side comparison of amplitudes and terminal latencies of the compound muscle action potentials (CMAP) of the facial muscles in the patients with Bell's palsy. Methods: Electroneurographic recordings with surface electrodes on the frontalis, orbicularis oculi, nasalis, and orbicularis oris muscles were made within 2 weeks post-onset (mean, day 7) in 39 patients. Results: Of the 39 Bell's palsy patients, 38 patients (97.4%) recovered satisfactorily within 6 months. The amplitude of CMAP in all patients was not reduced to 10% or less of that of the contralateral healthy muscle. The correlation of amplitude change between four facial muscles was relatively strong, but the correlation of latency change was weak. When the electroneurographic values were compared in the four muscle groups, the general linear models procedure did not show any significant difference for CMAP amplitude and latency changes (p=0.62-0.63). Conclusions: This study did not show any significant clinical advantage of electroneurographic recordings in more than one facial muscle at the early stage of Bell's palsy.

• The Korean Journal of Pain
• /
• 제10권1호
• /
• pp.97-100
• /
• 1997

We treated a 56 year old male ailing of painful herpetic eruption on his 2nd, 3rd and 4th left cervical spinal segment. On the 18th day, patient also suffered an abrupt left facial palsy, accompanied with ongoing postherpetic neuralgia even though the skin eruption had been cured. This patient visited our pain clinic on his 46th day of illness and was teated with continuous cervical epidural block for 9 days, and stellate ganglion block plus oral analgesics and antidepressant for 12 days. The combination of treatments resulted in marked improvement of facial palsy and postherpetic neuralgia. A possible explanation of facial palsy accompanied with herpes zoster on cervical spinal segment could be related to Hunt's hypothesis that geniculate ganglion forms a chain connecting the high cervical ganglion below. Another possibility may be related to a compression injury of the facial nerve by long-term severe edema on the soft tissue of the face, the periauricular area and parotid gland around the facial nerve, and edema on the facial nerve itself emerging out from the cranium.

• 대한한방내과학회지
• /
• 제24권2호
• /
• pp.395-401
• /
• 2003

Facial nerver paralysis is classified as Supranuclear, Peripheral and Nuclear. It is mostly Spontaneous Peripheral Facial Paralysis(Bell's palsy) or Supranuclear Paralysis by C.V.A, but Nuclear Facial Nerve Paralysis is rarely reported. We treated a 64-years-old female patient who had 7-years history of C.V.A with hypertension and heart disease, and complained of these symptoms; left facial palsy, ocular dysmetria, diplopia, and right extremity weakness. We diagnosed as direct attack from the wind pathogen(風邪入中) with deficiency of both Gi(Qi, vital energy) and blood(氣血雨虛), and employed Oriental medical treatments; herb-medication, acupuncture and moxa therapy. The result was relatively acceptable. So We report this case with a brief review of related literatures.

• Journal of Acupuncture Research
• /
• 제39권1호
• /
• pp.70-75
• /
• 2022

Two patients with sequelae of peripheral facial nerve palsy were treated with Facial Chuna Manual Therapy (FCMT) and acupuncture over 6 months. The House-Brackmann (HB) scale, facial nerve grading system 2.0 (FNGS), the scale of Peitersen, the scale of Murata, and the Numeric Rating Scale (NRS) were used to assess the effects of treatment. The HB scale, FNGS and NRS scores showed improvement for both patients (Case 1: HB scale 5 to 3, FNGS 4 to 2, NRS 10 to 5; Case 2: HB scale 5 to 3, FNGS 4 to 3, NRS 10 to 2.5) following 6 months of treatment. The scores for the Peitersen and Murata scales showed improvement over 6 months in Case 1 (Peitersen 2 to 1, Murata 10 to 7), but there was no change in Case 2 over the test period (4 months). FCMT and acupuncture may help patients with sequelae of facial palsy.

• 대한임상검사과학회지
• /
• 제50권4호
• /
• pp.470-476
• /
• 2018

다중펄스경두개전기자극(mpTES)을 이용한 안면운동유발전위(FMEP)는 자유 진행 근전도와 직접적인 안면 신경 자극법의 한계점을 보완하고 소뇌교각 종양 수술 중에 안면 신경의 기능적인 완전성을 예측할 수 있다. 본 논문의 목적은 이 검사의 표준화된 검사방법과 안면 신경의 기능예측인자로서의 유용성을 알아보고 수술 후 중대한 후유증인 안면마비 발생률을 최소화하는 것이다. Mz (음극)-M3, M4 (양극) 전극으로 경두개전기자극을 주고 안면운동유발전위의 단일펄스반응(SPR)의 부재와 10 ms이상의 잠복기를 확인해서 직접적인 두개 외 말초 안면 근육 자극을 배제하고 구륜근(orbicularis oris)과 턱근(mentalis)에서 동시에 측정하면 구륜근에서만 측정했을 때보다 안면운동유발전위의 정확도와 성공률을 높일 수 있다. 본 논문에서는 안면운동유발전위의 50% 진폭감소를 경고기준으로 해서 수술 직후 안면 신경의 결과를 효과적으로 예측할 수 있었다. 결론적으로, 소뇌교각 종양 수술 중에 FMEP는 자유 진행 근전도와 직접적인 안면 신경 자극법과 더불어서 수술 후 중대한 후유증인 안면 마비 발생률을 최소화 할 수 있는 유용한 검사방법이다.

• Journal of Acupuncture Research
• /
• 제33권2호
• /
• pp.211-220
• /
• 2016

Objectives : Facial nerve palsy is a rare but well-known complication that occurs after a tooth extraction. The paralysis follows the injection of a local anesthetic, but patients typically recover after a few hours. However, there are a number of reports of delayed paralysis, and the cause of delayed facial palsy remains uncertain. This study is the first case report detailing how Korean medicine can be used to treat facial nerve palsy following tooth extraction. This study reports our experience of a patient's favorable recovery. Methods : A 25-year-old male patient experienced acute facial palsy after four premolar teeth were extracted. He was hospitalized in the Pusan National University Korean Medical Hospital. We provided complex Korean traditional medical treatments such as acupuncture, cupping, use of a hot water steamer, and herbal medicine for 18 days. Results : Using the Yanagihara Grading Score, we found improvements in the patient's voluntary facial movement as his score increased from 22 to 34. Furthermore, his accompanying symptoms, such as dry eye and facial pain, disappeared. However, the patient reported transient pain around acupoints after the acupuncture intervention. Conclusion : Our study suggests that Korean medical treatments might be effectively used to treat facial nerve palsy after tooth extraction, although further research should be conducted due to the limited number of cases in this area.