• 대한두경부종양학회지
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• 제15권2호
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• pp.200-204
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• 1999

Objectives: Injuries of neurologic structures during parotid surgery are sometimes unavoidable even in benign tumors. Since the major postoperative neurologic complications such as facial nerve palsy and Frey's syndrome give a serious and heavy burden to both patients and surgeons, it is very important to know detailed information concerning risk factors, the incidence of complication, possibility of recovery, and the term before complete recovery. Materials and Methods: This report was based on 95 patients with parotid gland tumor who had been treated and followed up over 1 year at department of surgery and otolaryngology, chonnam university hospital. Results: 1) Among total 95 cases, the facial nerve palsy developed in 18 cases(l8.9%) and Frey's syndrome in 6 cases(6,3%). 2) The incidence of facial nerve palsy increased in cases with large tumor size, and in those operated with bipolar method. However, we didn't find out relationships between the incidence of facial palsy, localization, and histologic type. 3) The incidence of Frey's syndrome showed an increasing tendency in the cases with large tumor size, benign nature, and in those underwent superficial lobectomy with posterior approach, without a statistical significance. Conclusions: Risk of facial nerve palsy, especially a transient form, seems to be related to tumor size and bipolar coagulation method. Although Frey's syndrome tends to develop easily in the cases treated with superficial lobectomy under the diagnosis of benign tumor, a futhermore study is suggested to obtain a statistical significance.

• 대한두개안면성형외과학회지
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• 제21권4호
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• pp.244-248
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• 2020

The infraorbital nerve is a branch of the trigeminal nerve. Injury to the infraorbital nerve can be caused by trauma, including various facial fractures. Due to this nerve injury, patients complain of numbness and pain in the entire cheek, the ala of nose, and upper lip. In general, spontaneous sensory recovery is expected after decompressive surgery. If nerve transection is confirmed, however, neurorrhaphy is typically performed. Here, we present a case in which microsurgery was not performed in a patient with Sunderland grade V avulsion injury of the infraorbital nerve due to a facial bone fracture. Gradual nerve function recovery was confirmed to be possible with conservative treatment and rehabilitation alone. These findings suggest that the nerve function recovery can be expected with conservative treatment, even for severe nerve injury for which microsurgery cannot be considered.

• 대한한의학회지
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• 제29권3호
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• pp.131-143
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• 2008

Objectives: Electroacupuncture has the effect of recovering paralytic nerves and muscles. To treat disproportional muscles of expression with electroacupuncture, it is essential that we know the correct point of paralytic muscle. Methods: We investigated 20 cases of patients with facial palsy sequelae. We measured nasolabial angles, checked grade of muscle palsy, and tested ENoG. Results: This study showed significant correlation between nasolabial angles with these muscle groups (zygomatic group I, zygomatic group II, orbicularis oris muscle). Conclusions: Disproportional facesare fixed by muscles of expression observed in facial palsy sequelae. We can treat muscular paralysis of these muscle groups with electroacupuncture for more complete recovery.

• 대한한방소아과학회지
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• 제27권3호
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• pp.20-28
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• 2013

Objectives The purpose of this study is to report the clinical effects of Korean medical treatments on peripheral facial palsy. Methods In this study, 5 children were treated with peripheral facial palsy with Korean medical treatments, such as herb medicines, acupunctures, electro-acupuncture, and infrared therapy. Results As a result of the treatment, 5 children were almost recovered. The average treatment period was 42.17 days, with average recovery period of 9 weeks. Conclusions This study shows that Korean medical treatments on childhood peripheral facial palsy could be one of the viable options for this patient kind.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.43-47
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• 2011

Purpose: Sensory impairment in infraorbital nerve is common symptom following mid-facial fractures. The purpose of this study is to document the incidence of sensory impairment in infraorbital nerve following midfacial fractures and its recovery. Methods: Three hundreds fourteen patients with midfacial fracture were included involving emergence areas of infraorbital nerve. Fractures were classified into zygoma fracture, maxilla fracture, complex comminuted fracture and pure blow out fracture. Neurosensory function was assessed with clinical symptoms and light touch test in infraorbital nerve regions. Patients were followed and sensory function was evaluated immediately, 1, 3 and 6 months after trauma. Results: The total series consisted of 198 zygoma fractures, 19 maxilla fractures, 30 complex comminuted fractures and 67 pure blow out fractures. The incidence of sensory impairment was 60% (63% in zygoma fractures, 84% in maxilla fractures, 93% in complex comminuted fractures, 31% in pure blow out fractures). Persistent sensory impairments were remained in 32% (33% in zygoma fractures, 47% in maxilla fractures, 73% in complex comminuted fractures, 6% in pure blow out fractures) 6 months after trauma. Younger patients had better prognosis than older patients in recovery of infraorbital nerve function ($p$ <0.05, $x^2$-test). Mean recovery time was 11 weeks. Conclusion: The incidence of post-traumatic sensory impairment was different according to fracture types. Age of patients and fracture type were important factors that influence to recovery of sensory impairment. Complex comminuted fracture had poor prognosis, and pure blow out fractures had better prognosis than other fractures.

• Journal of Oral Medicine and Pain
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• 제26권2호
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• pp.157-160
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• 2001

Facial nerve paralysis(or Bell's palsy) which commonly occurs unilaterally, gives rise to paralysis of facial expression muscle. This condition is classified into symptomatic facial nerve paralysis due to intracranial tumor, post operative trauma, etc. and idiopathic facial nerve paralysis. To explain the etiology of idiopathic facial nerve paralysis, many hypothesis including ischemic theory, viral infection, exposure to cold, immune theory etc. were suggested, but there is no agreement at this point. The method to evaluate the facial nerve paralysis, when it occurs, consists of three stage scale method, image thechnics like CT and MRI, laboratory test to examine the antibody titers of viral infection, neurophysiologic test to evaluate the degree and prognosis of paralysis. Treatment includes medication, stellate ganglion block(SGB), surgery, physical therapy and other home care therapy. In medication, systemic steroids, vitamins, vasodilating-drug and ATP drugs were used. SGB was also used repeatedly to attempt the improvement of circulation and to stimulate the recovery of nerve function. Physical therapy including electric acupuncture stimulation therapy(EAST) and hot pack was used to prevent the muscle atrophy. When No response was showed to this conservative therapies, surgery was considered. After treating two patients complaining of Bell's palsy with medication(systemic steroids) and EAST, favorable result was obtained. so author report the case of facial nerve paralysis.

• Journal of Acupuncture Research
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• 제18권2호
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• pp.1-17
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• 2001

Background and Objetive : Lack of uniformity in reporting facial nerve recovery in patients with facial nerve paralysis has been a major disadvantage in comparing treatment modalities. The objective evaluation of facial nerve function is a complex procedure. The House and Brackmann grading system, the Yanagihara grading system has been recommend as a universal standard for assessing the degree of facial nerve palsy. However, clinical studies for treatment of facial palsy have rarely used this universal standard in oriental medicine. That is the reason for analysing this facial nerve grading system. Material and Method : We choose 10 scales reported from 1955 till 1995. These facial nerve grading systems may be classified as Gross system, Regional system and Specific system. Result and Conculsion : The scales of Botmann and Jonkees, May, Peitersen, and House and Brackmann are the gross facial nerve grading systems with which we grossly assess the facial motor dysfunction and the secondary defect. Among these scales, H-B scale is the most widespred The scales of Yanagihara(若杉文吉), Smith, Adour and Swanson, Jassen, FEMA are the regional facial nerve grading system in which we weight, or unweight the facial motor dysfunction and the secondary defect. For example, the scales of Yanagihara(若杉文吉) and Smith are the unweighted regional scale, the scale of Adour and Swanson, Jassen, FEMA are the weighted regional grading system. The scale of Stennert is the Specific facial nerve grading system in which we respectively assess the grade of facial dysfunction at rest, in motion and the secondary defect. For the objective evaluation of the oriental medicine treatment for facial palsy, we must use the universal standard scale, i.e. the H-B scale, the Yanagihara scale.

• Archives of Plastic Surgery
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• 제42권4호
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• pp.461-468
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• 2015

Background Functional restoration of the facial expression is necessary after facial nerve resection to treat head and neck tumors. This study was conducted to evaluate the functional outcomes of patients who underwent facial nerve cable grafting immediately after tumor resection. Methods Patients who underwent cable grafting from April 2007 to August 2011 were reviewed, in which a harvested branch of the sural nerve was grafted onto each facial nerve division. Twelve patients underwent facial nerve cable grafting after radical parotidectomy, total parotidectomy, or schwannoma resection, and the functional facial expression of each patient was evaluated using the Facial Nerve Grading Scale 2.0. The results were analyzed according to patient age, follow-up duration, and the use of postoperative radiation therapy. Results Among the 12 patients who were evaluated, the mean follow-up duration was 21.8 months, the mean age at the time of surgery was 42.8 years, and the mean facial expression score was 14.6 points, indicating moderate dysfunction. Facial expression scores were not influenced by age at the time of surgery, follow-up duration, or the use of postoperative radiation therapy. Conclusions The results of this study indicate that facial nerve cable grafting using the sural nerve can restore facial expression. Although patients were provided with appropriate treatment, the survival rate for salivary gland cancer was poor. We conclude that immediate facial nerve reconstruction is a worthwhile procedure that improves quality of life by allowing the recovery of facial expression, even in patients who are older or may require radiation therapy.

• Journal of Acupuncture Research
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• 제19권1호
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• pp.11-23
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• 2002

Objective : Lately oriental medicine treatment of peripheral facial paralysis is various. In various treatments, this study makes a report that effect of our clinic using aqua-acupuncture with hominis placenta for peripheral facial paralysis. Materials and Methods : This report have been observed among twenty-six patients with peripheral facial paralysis who admitted to oriental medicine hospital with Se-myung university during Jan. 1st, 2001 to Oct. fourth, 2001. These patients were divided into two groups; the first group added aqua-acupuncture with hominis placenta to basic oriental medicine treatment., while the second group was only treated with basic oriental medicine treatment. Results : The results of treatment with adding aqua-acupuncture with hominis placenta to basic oriental medicine treatment showed that 9 of 12(75%) patients achieved good or more recovery. While the second group was observed that 6 of 14(50%) patients achieved good or more recovery. Conclusion : The outcome of the observation, we concludes that the therapeutic rate of the group of adding aqua-acupuncture with hominis placenta was higher than that of basic oriental medicine treatment.

• 대한치과교정학회지
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• 제20권1호
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• pp.23-45
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• 1990

It is the aim of this study to determine the effects of facial denervation on physiological properties of facial muscles and facial bones in growing rabbits. Experimental animals of fifty two Oryctolagus cuniculus rabbits were employed. Unilateral dissection of facial nerve was carried out on twelve rabbits, bilateral dissection of facial nerve was made on another twelve rabbits and the other twenty rabbits were on unilateral dissection of facial nerve for the histochemical analyses. Six rabbits on the bilateral surgical sham operations and six rabbits of non-intervention served the control groups. EMG records of the orbicularis oris, buccinator and masseter muscles as well as lateral and dorsoventral cephalometric films were taken and analyzed at 0, 1, 2, 5 and 8 weeks respectively. The orbicularis oris, buccinator and masseter muscles of both sides were removed from the animals of the histochemistry group and muscle fibers were classified on the basis of histochemical staining for $\alpha$-GPD, NADH-D and myosin ATPase. EMG activities of orbicularis oris and buccinator muscles were vanished immediately after denervation. Recovery of activities were detected one week after denervation in buccinator and five weeks in orbicularis oris muscles. Histochemical properties of masseter muscles remained as fast glycolytic through the experimental period. Orbicularis oris muscle fibers showed the gradual diminution of size and ratio of the slow oxidative fibers accompanied with atrophy, phagocytosis and vacuolation as well as the augmentation of fast oxidative glycolytic fibers. The buccinator muscle manifested the augmentation of fast oxidative glycolytic fibers at five weeks of experiment. Visual changes in morphology of craniofacial area were not evident, however it variety of subtle changes were apparent from statistical analysis of cephalometric measurements. It is concluded facial nerve regulates the physiological properties of facial muscles and interrelation between the function of the facial muscles and changes of facial bones would be in some degrees.