• Archives of Plastic Surgery
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• 제32권3호
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• pp.281-286
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• 2005

The goal in facial paralysis treatment is to achieve the normal appearance of the face as well as to reconstruct the natural symmetrical smile. In cases of facial paralysis, a widely accepted procedure is the two stage method, which combines neurovascular free muscle transfer with cross face nerve grafting. Although the results are promising, the two operations of this method, which are about 1 year apart, impose an economic burden on the patients and require a lengthy period before results are obtained. In order to overcome these drawbacks, one stage method, using latissimus dorsi neurovascuular free muscle flap was introduced. Between January 2000 and January 2004, fifteen patients with long standing facial paralysis were treated in the Korea University Anam Hospital. The segmental latissimus dorsi with long nerve and pedicle was transferred to the paralyzed side of the face. The first postoperative movement of the transferred muscle was reported at 8.9 months, faster than that of the two stage method. During the next 24 months, a constant increase in the power of muscle contraction was observed. The fifteen cases were evaluated within an average of 31.7 months following the surgery and satisfactory results including muscle contraction were obtained in eleven of the cases but muscle contraction was not found in three cases.

• Annals of Clinical Neurophysiology
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• 제6권2호
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• pp.75-79
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• 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 Journal of Korean Physical Therapy
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• 제33권6호
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• pp.297-303
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• 2021

Purpose: The mass of facial muscles can be increased through exercise, as is also the case for muscles in the extremities. This systematic review was conducted to investigate the effect of facial exercises on facial muscle strengthening and facial rejuvenation, focusing on recent studies. Methods: A literature search was performed using the PubMed, ScienceDirect, and Web of Science databases. The quality of the trials was evaluated according to the PEDro scale. In total, 11 studies were included in this review: four studies on facial exercise for facial rejuvenation and seven studies on strengthening the muscles of the face. Results: Facial exercises for facial rejuvenation increased the mechanical properties and elasticity of the skin of the face and neck, the thickness and cross-sectional area of the facial muscles, and the fullness of the upper and lower cheeks. Conclusion: A study aimed at strengthening facial muscles showed improvements in labial closure strength and tongue elevation strength. Despite the positive results for facial rejuvenation and muscle strengthening, the level of evidence was low. Therefore, in future research, it will be necessary to investigate the effects of facial exercise in a thoroughly controlled experiment with a sufficient sample size to increase the level of evidence.

• Journal of Acupuncture Research
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• 제32권4호
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• pp.69-76
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• 2015

Objectives : The aim of this study was to observe the effect of Embedding therapy on complete facial palsy after primary treatment. Methods : 11 patients with complete facial palsy were treated with Embedding therapy. It was performed once a day, every two weeks. 15~20 Embedding threads were used in each Embedding therapy treatment. The total number of Embedding therapy treatments was 4 or 8. Frontalis muscles (including the Yangbaek ($GB_{14}$)), Orbicularis oculi muscle, Levator labii superioris muscle, Zygomatic major muscle, Zygomatic minor muscle (including the Georyo ($ST_3$) and Jichang ($ST_4$)), Masseter muscle, Buccinator muscle (including the Hyeopgeo ($ST_6$)) and Orbicularis Oris muscle were selected. Yanagihara's score and House-Brackmann scale were compared for before and after treatment to evaluate the effect of Embedding therapy. Results : Yanagihara's score increased significantly (p=0.003). House-Brackmann Scale decreased significantly (p=0.005). Three patients were extremely satisfied, six patients were satisfied, and two patients responded neutrally in regards to Embedding therapy. Conclusions : Embedding therapy can be effective in improving symptoms of complete facial palsy.

• 한국정보통신학회:학술대회논문집
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• 한국해양정보통신학회 2009년도 추계학술대회
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• pp.289-292
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• 2009

사람은 주로 언어를 통해 서로간의 의사를 표현한다. 하지만, 말을 할 수 없는 중증 장애인, 특히 전신마비 증세가 있는 중증 장애인의 경우에는 글을 쓰거나 몸짓을 통한 방법으로도 자신의 의사를 전달하지 못한다는 문제점이 있다. 따라서, 본 논문에서는 이러한 중증 장애인이 의사 소통을 할 수 있도록 안면근 신호를 이용한 의사 전달기를 구현하였다. 특히, 안면근 신호가 포함된 뇌파의 특징을 추출하여 이를 일반적인 제어 신호로써 변환한 다음, 이 제어 신호와 최소한의 자판을 연동시켜 문자를 선택하도록 함으로써, 중증 장애인이 효율적으로 의사를 전달할 수 있도록 하였다.

• The Journal of Korean Physical Therapy
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• 제26권4호
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• pp.240-248
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• 2014

Purpose: The purpose of study was to determine the effects of muscle reeducation training in patients with acute facial nerve paralysis. Methods: Thirty patients were randomly assigned to either the experimental group (n=15) or the control group (n=15). The experimental group received muscle reeducation training for 20 minutes after electrotherapy and the control group received conventional electrotherapy for only 40 minutes. Therapeutic intervention for each group was performed four times per week for four weeks. The patients were measured for recovery of paralysis using the House-Brackmann Grading System (H-B grade), the Movement Distance of Mouth, Nasolabial Angle (NA), and Facial Disability Index (FDI). Results: In within group comparison, the experimental group showed significant improvements for all variables (p<0.01). In comparison between two groups, the experimental group showed relatively greater significant improvements for all variables (p<0.01). Conclusion: These findings suggest that muscle reeducation training is more effective than conventional therapy in improving the condition of patients with facial nerve paralysis. In particular, the results of this study indicate that muscle reeducation training can be recommended by clinicians since it provides more benefits.

• Annals of Clinical Neurophysiology
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• 제7권2호
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• pp.88-92
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• 2005

Blink reflex could be a useful tool to differentiate facial synkinesis as one of complications of facial neuropathy, from volitional associated movements. We had performed applied blink reflex test for 23 patients with objective evidence of hemifacial weakness in which orbicularis oculi muscle(zygomatic branch) and mentalis muscle(mandibular branch) are electrophysiologically evaluated in response to supraorbital stimulation of trigeminal nerve. For an unaffected side of face there is no evidence of positive blink reflex from the mentalis muscle. We concluded that a positive blink reflex from mentalis muscle is almost always suggestive of chronic facial neuropathy even in clinical silence of facial synkinesis, or an aberrant reinnervation after peripheral facial neuropathy, and does not electrophysiologically correlate with the severity of facial palsy.

• 대한물리치료과학회지
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• 제16권1호
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• pp.1-10
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• 2009

Background: The purpose of this study was to determine the effect of massage and muscle reeducation training with conventional treatment in patients with facial paralysis. Methods: Twenty-five patients with facial nerve paralysis were randomly allocated to 3 groups: massage, muscle reeducation training, and control groups. Therapeutic intervention for the massage (n=8) and muscle reeducation training (n=8) groups consisted of conventional therapy such as application of hot pack and electrical stimulation plus massage therapy and muscle reeducation training, respectively. The control group (n=9) received only conventional therapy. Therapeutic intervention for each group was performed 6 times per week for 4 weeks. The patients were assessed by using the House-Brackmann Grading System (H-B grade) and Yanagihara Unweighted Grading System (Y grade) once every week. Results: The H-B and Y grades improved significantly in all 3 groups after a 4-week intervention (p<.01). At 3 and 4 weeks, the H-B and Y grades of the massage group improved significantly when compared with those of the control group (p<.01). Muscle reeducation training group showed significant improvements in the scores of the two grades with time when compared with the massage and control groups (p<.01). The rate of change in the H-B grade was significantly different between the control and muscle reeducation training groups (p<.01), and that of change in the Y grade was significantly different between the control and muscle reeducation training groups (p<.01) and between the control and massage groups (p<.01). Conclusion: These findings suggest that massage and muscle reeducation training are more effective in improving the condition of patients with facial nerve paralysis than conventional therapy. In particular, the results of this study indicate that muscle reeducation training can be recommended by clinicians since it provides more benefits.

• 한국감성과학회:학술대회논문집
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• 한국감성과학회 2012년도 춘계학술대회
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• pp.75-76
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• 2012

• 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.