• 대한두경부종양학회지
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• 제28권2호
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• pp.125-128
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• 2012

Salivary duct carcinoma(SDC) is a highly malignant tumor of the salivary gland. The tumor is clinically characterized by a rapid onset and progression, the neoplasm is often associated with pain and facial paralysis. The nodal recurrence rate is high, and distant metastasis is common. SDC resembles high-grade breast ductal carcinoma. Curative surgical resection and postoperative radiation were the mainstay of the treatment. If facial paralysis is present, a radical parotidectomy is mandatory. Regardless of the primary location of SDC, ipsilateral functional neck dissection is indicated, because regional lymphatic spread has to be expected in the majority of patients already at time of diagnosis. If there is minor gland involvement, a bilateral neck dissection should be performed, because lymphatic drainage may occur to the contralateral side. The survival of SDC patient is poor, with most dying within three years. We experienced a unique case of SDC in parotid deep lobe. We report the clinicopathologic features of this tumor with a review of literature.

• 한방안이비인후피부과학회지
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• 제14권2호
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• pp.198-206
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• 2001

Recurrent Bell's palsy is a very rare case and have been reported that shows the incidence to be approximately 10 per cent in the Bell's palsy patents. It is generally accepted that facial paralysis caused by compression of the facial nerve by tumor develops slowly and has an unremitting course, however, reported cases have described the rare association of recurrent facial paralysis and intracranial tumor, and the same recovery rate. Usual symptoms of Bell's palsy include subacute facial palsy, hyperacusis on the affected side, postauricular pain on the affected side, altered sensation of taste, and partial trigeminal distribution hypesthesias. Complete resolution of symptoms is usually seen in 2-3months in $75-85\%$ of cases, with $25-35\%$ showing varying degrees of residual effects. We report a case of 4th ipsilateral recurrent Bell's palsy in a 14-year-old women, which was occurred in every winters. We treated her with acupuncture, moxibustion, herbal medication, carbon and silver spike point, and used House-Brackmnn grading system(HBGS) and the Fisch Detailed Evaluation of Facial Symmetry(DEFS) to assess the degree of paralysis in each part of face.

• 한국임상수의학회지
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• 제25권4호
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• pp.245-248
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• 2008

한약제는 사람의 많은 질병의 치료를 위하여 사용되어 왔으나, 개 안면신경마비에 대한 한약제의 치료 효과는 현재까지 검토된 바 없다. 개 안면신경마비에 대한 오약순기산의 치료 효과를 조사하였다. 인공적으로 안면신경마비를 유발한 총 10두 대조군(5두)과 한약제 치료군(5두,오약순기산 치료군)으로 나누어 공시하였다. 대조군은 아무런 처치를 하지 않았으며,오약순기산 치료군은 1일 2회, 총 2주간 오약순기산(50 mg/kg)을 경구 투여하였다. 오약순기산 치료군의 임상 지표는 대조군에 비하여 14일(p<0.05)에 유의성 있는 개선을 보였다. 오약순기산 치료군의 혈청 CK 활성 변화는 대조군에 비하여 낮은 경향을 나타냈지만 유의성은 인정되지 않았다. 결론적으로, 오약순기산은 개 안면신경마비 치료에 유효한 것으로 판단되었다.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.131-138
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• 2013

Purpose: The aim of this study is to present a retrospective review of patients who had a sudden onset of facial palsy after trauma and who underwent facial nerve decompression. Methods: The cases of 25 patients who had traumatic facial palsy were reviewed. Facial nerve function was graded according to the House-Brackmann grading scale. According to facial nerve decompression, patients were categorized into the surgical (decompression) group, with 7 patients in the early decompression subgroup and 2 patients in the late decompression subgroup, and the conservative group(16 patients). Results: The facial nerve decompression group included 8 males and 1 female, aged 2 to 86 years old, with a mean age of 40.8. In early facial nerve decompression subgroup, facial palsy was H-B grade I to III in 6 cases (66.7%); H-B grade IV was observed in 1 case(11.1%). In late facial nerve decompression subgroup, 1 patient (11.1%) had no improvement, and the other patient(11.1%) improved to H-B grade III from H-B grade V. A comparison of patients who underwent surgery within 2 weeks to those who underwent surgery 2 weeks later did not show any significant difference in improvement of H-B grades (p>0.05). The conservative management group included 15 males and 1 female, aged 6 to 66 years old, with a mean age of 36. At the last follow up, 15 patients showed H-B grades of I to III(93.7%), and only 1 patient had an H-B grade of IV(6.3%). Conclusion: Generally, we assume that early facial nerve decompression can lead to some recovery from traumatic facial palsy, but a prospective controlled study should and will be prepared to compare of conservative treatment to late decompression.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권3호
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• pp.288-297
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• 2005

Rehabilitation of the paralyzed face as a result of trauma or surgery remains a daunting task. Complete restoration of emotionally driven symmetric facial motion is still unobtainable, but current techniques have enhanced our ability to improve this emotionally traumatic deficit. Problems of mass movement and synkinesis still plague even the best reconstructions. The reconstructive techniques used still represent a compromise between obtainable symmetry and motion at the expense of donor site deficits, but current techniques continue to refine and limit this morbidity. In chronically paralyzed face, direct nerve anastomosis, nerve graft, or microvascular-muscle graft is not always possible. In this case, regional muscle transposition is tried to reanimate the eyelid and lower face. Regional muscle includes maseeter muscle, temporalis muscle and anterior belly of the digastric muscle. Temporalis muscle is preferred because it is long, flat, pliable and wide-motion of excursion. In order to reanimate the upper and lower eyelid, Upper eyelid Gold weight implantion and lower eyelid shortening and tightening is mainly used recently, because this method is very simple, easy and reliable.

• Journal of Acupuncture Research
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• 제19권2호
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• pp.238-249
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• 2002

Facial palsy is commonly encountered disease in the clinic but bilateral facial palsy is known as rare disease. Type of facial nerve paralysis include unilateral, recurrent ipsilateral, recurrent alternating and bilateral simultaneous palsies. Among the types, the reported incidence of bilateral simultaneous palsy is 0.3~2% of facial paralysis patients. We experienced I case of patient with bilateral simultaneous facial palsy that was concluded as bilateral bell's palsy. Objective : The purpose of this paper is to report the patient with bilateral facial palsy, who improved by oriental medical treatment. Another purpose is to review the current literature and to differential diagnosis of bilateral facial paralysis. Methods and Results : The patient was treated by acupuncture, herb medication and self-massage on facial muscle for 14 weeks. House-brackmann grading score was improved into I/I (Rt/Lt) from IV/IV. Conclusion : Through reviewing some literatures and reports, It is concluded that bilateral facial palsy was related to many other disorders and more ominous than unilateral facial palsy. therefore, its work-up should include a complete neurologic assesment and thorough evaluation. also, we consider that bilateral Bell's palsy can improve by oriental medical treatments.

• 한방안이비인후피부과학회지
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• 제23권3호
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• pp.109-121
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• 2010

Objectives : This study was performed to analysis the effect of oriental medical care for inpatients with facial paralysis that had visited Dept. of Otolaryngology Oriental medical hospital Dong-eui university. Methods : From January 2008 to September 2010, a clinical study was done on 250 inpatients who were treated as facial nerve paralysis at the Dept. of Otolaryngology Oriental medical hospital Dong-eui university. This study was assessed using the chart analysis. Results : 1. The distribution of sex : female 54.8%, male 45.2%. The distribution of age was pregented that fifty to sixty was the most in 67 cases(26.8%). 2. The distribution of the period of admission : female 12.5 days, male 9.9 days. 3. The distribution of past history : hypertention(18.8%), diabetes-mellitus(10.85%), facial paralysis(9.25%), cerebrovascular disease(4.4%), liver disease(5.6%), hyperlipidemia(1.2%), otitis media(1.2%), herpes zoster(1.2%), cardiac disease(2.45%), thyroid disease(1.2%). 4. The distribution of the region of facial paralysis : Rt(55.36%), Lt(56.52%). 5. Check the mastoid pain : 66.8%(female 73.91%, male 58.04%). 6. Out of prescription(Ko-Bang, 古方), Galgeun-Tang(葛根湯) and Gaejigeogaegayoungchul-Tang was used most in each 34 cases, Daesiho-Tang(大柴胡湯) 30 cases, Galgeungabanha-Tang(葛根加半夏湯) 27 cases, Sihogaeji-Tang(柴胡桂枝湯) 14 cases, Hwanggigaejiomul-Tang 12 cases, Odu-Tang(烏頭湯) 10 cases, Chijadaehwangsi-Tang 10 cases, Gaejigagalgeun-Tang(桂枝加葛根湯) 7 cases, Banhasasim-Tang(半夏瀉心湯) 5 cases, Injinho-Tang(茵蔯蒿湯) 5 cases in order. 7. The distribution of herb group : Mahwang-Jae(麻黃劑) 31.72%, Gaeji-Jae(桂枝劑) 26.00%, Siho-Gae(柴胡劑) 20.70%, Chija-Gae(梔子劑) 7.49%, Buja-Jae(附子劑) 4.41%, Banhahwanggeum-Gae(半夏黃芩劑) 3.08%, Daehwang-Gae(大黃劑) 2.64%, Bockryeong-Gae(茯笭劑) 1.76%, Jisil-Gae(枳實劑) 1.32%, Insam-Gae(人蔘劑) 0.88% in order. 8. The distribution of House-Brackmann grade of admission : Gr Ⅳ 74.85%, Gr.III 13.6%, Gr.V 11.6% in order. 9. The distribution of House-Brackmann grade of discharge : Gr.III 56%, Gr.IV 38.4%, Gr.II 5.6% in order. 10. The average number of OPD follow up is 6.46. Conclusion : This results indicated that oriental medical treatment with Ko-bang(古方) can be an effective way to treat facial paralysis. The more patients we treat with Ko-bang(古方), the more clinical report is accumulated. Then it would be helpful to map out a systematic treatment on facial paralysis.

• 대한한방내과학회지
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• 제40권5호
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• pp.760-767
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• 2019

Objective: This study reports the efficacy of using integrative Korean medicine treatments for a patient with facial paralysis and accompanying trigeminal neuralgia. Methods: A 45-year-old male patient with left side facial palsy and facial pain due to Bell's palsy with trigeminal neuralgia was treated with herbal medicine, acupuncture, pharmacopuncture, and cupping for 18 days. The treatment effect was evaluated by measuring the scores for the numerical rating scale (NRS) of facial pain, the House-Brackmann scale, and the Yanagihara scale. Results: After the hospital treatment, the patient's facial pain NRS score was decreased, and the House-Brackmann scale and Yanagihara scale scores improved after the administration of the Korean medicine treatments. Conclusions: The integrative Korean medicine treatments appeared to be effective in treating facial nerve palsy and associated trigeminal neuralgia.

• 대한치과마취과학회지
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• 제11권1호
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• pp.45-50
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• 2011

Bell's palsy is an isolated facial paralysis of sudden onset caused by a neuritis of the seventh nerve within the facial canal. It occurs often in the adult man with a history of recent exposure to local cold, such as sleeping next to an open window, or in some cases it occurs after infections of the nasopharynx or masticator spaces. Especially, this neuropathy have linked with the major collagen disorders (diabetes mellitus). A segmental demyelination develops rapidly, with vascultitis in microinfarcts and ischemia to the nerve segment. The authors experienced about the bizarre neurological symptom of Bell's palsy after inferior alveolar nerve block anesthesia and TMJ dislocation in diabetic mellitus. The early and correct consultation with the multiple medical and dental departments was important to prevent the inadequate care & medicolegal problems.

• Archives of Plastic Surgery
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• 제40권4호
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• pp.348-352
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• 2013

Background Temporalis muscle transfer produces prompt surgical results with a one-stage operation in facial palsy patients. The orthodromic method is surgically simple, and the vector of muscle action is similar to the temporalis muscle action direction. This article describes transferring temporalis muscle insertion to reconstruct incomplete facial nerve palsy patients. Methods Between August 2009 and November 2011, 6 unilateral incomplete facial nerve palsy patients underwent surgery for orthodromic temporalis muscle transfer. A preauricular incision was performed to expose the mandibular coronoid process. Using a saw, the coronoid process was transected. Three strips of the fascia lata were anchored to the muscle of the nasolabial fold through subcutaneous tunneling. The tension of the strips was adjusted by observing the shape of the nasolabial fold. When optimal tension was achieved, the temporalis muscle was sutured to the strips. The surgical results were assessed by comparing pre- and postoperative photographs. Three independent observers evaluated the photographs. Results The symmetry of the mouth corner was improved in the resting state, and movement of the oral commissure was enhanced in facial animation after surgery. Conclusions The orthodromic transfer of temporalis muscle technique can produce prompt results by applying the natural temporalis muscle vector. This technique preserves residual facial nerve function in incomplete facial nerve palsy patients and produces satisfying cosmetic outcomes without malar muscle bulging, which often occurs in the turn-over technique.