• 대한족부족관절학회지
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• 제14권1호
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• pp.90-96
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• 2010

Purpose: The purpose of this study is to investigate the usefulness of ultrasound-guided femorosciatic nerve block by orthopaedist to operate the fracture around ankle. Materials and Methods: Twenty-two patients, who had an operation for fracture around the ankle under a ultrasound-guided femorosciatic nerve block from January to April 2010, were the targets of this study. We measured the time spent for the ultrasound-guided femorosciatic nerve block, the time taken to start the operation after the nerve block, the time taken to deflate the tourniquet because of a tourniquet pain, the time passed until feeling a postoperative pain after the operation, etc. We also studied the complications and satisfaction of the anesthesia. Results: It took 6.2 (3 to 12) minutes for the nerve block, 46.1 (28 to 75) minutes to start the operation, 52.5 (22 to 78) minutes until feeling a tourniquet pain and 11.5 (7.5 to 19) hours until starting to feeing a postoperative pain. There was no complication by anesthesia and 21 people (95.5%) were satisfied with anesthesia by ultrasound-guided femorosciatic nerve block. Conclusion: Ultrasound-guided femorosciatic nerve block by orthopaedist in the fracture around ankle reduces anesthetic and nerve injury complication, and leads to high anesthetic success rate. Also it is considered as an effective method to alleviate postoperative pain.

• Archives of Plastic Surgery
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• 제44권4호
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• pp.261-265
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• 2017

Periauricular paresthesia may afflict patients for a significant amount of time after facelift surgery. When performing face and neck lift surgery, temple and posterior auricular flap dissection is undertaken directly over the auriculotemporal, great auricular, and lesser occipital nerve territory, leading to potential damage to the nerve. The auriculotemporal nerve remains under the thin outer superficial fascia just below the subfollicular level in the prehelical area. To prevent damage to the auriculotemporal nerve and to protect the temporal hair follicle, the dissection plane should be kept just above the thin fascia covering the auriculotemporal nerve. Around the McKinney point, the adipose tissue covering the deep fascia is apt to be elevated from the deep fascia due to its denser fascial relationship with the skin, which leaves the great auricular nerve open to exposure. In order to prevent damage to the posterior branches of the great auricular nerve, the skin flap at the posterior auricular sulcus should be elevated above the auricularis posterior muscle. Fixating the superficial muscular aponeurotic system flap deeper and higher to the tympano-parotid fascia is recommended in order to avoid compromising the lobular branch of the great auricular nerve. The lesser occipital nerve (C2, C3) travels superficially at a proximal and variable level that makes it vulnerable to compromise in the mastoid dissection. Leaving the adipose tissue at the level of the deep fascia puts the branches of the great auricular nerve and lesser occipital nerve at less risk, and has been confirmed not to compromise either tissue perfusion or hair follicles.

• 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.

• Annals of Clinical Neurophysiology
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• 제8권2호
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• pp.152-157
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• 2006

Background: Meralgia paresthesia (MP) is characterized by sensory impairment in the anterolateral aspect of the thigh and usually caused by a lateral femoral cutaneous nerve (LFCN) lesion. It is well known that several physiologic factors including age, obesity, and sex can affect nerve conduction. This study aimed to determine whether body mass index (BMI) and age can influence on the conduction velocity and action potential amplitude of the LFCN. Methods: Fifty six individuals without any previous neuromuscular disease participated in this study. LFCN was studied orthodromically, distally from the anterior superior iliac spine. The values, such as sensory nerve action potential (SNAP) amplitude and sensory nerve conduction velocity (NCV) were obtained. SNAP of the LFCN were formed on both sides in forty three individuals. Results: No difference of demographic factors was observed between two groups divided according to the presence of SNAP formation. BMI had a significant relationship with SNAP amplitude and NCV of the LFCN. Moreover, Multiple regression analyses of nerve conduction values showed the significant correlation of body mass index and age with nerve conduction velocity. Conclusions: We may suggest that nerve conduction of the LFCN can be affected by age and BMI. Further study to obtain normal nerve conduction data and compare these data with those of meralgia paresthetica patients should be continued.

• The Korean Journal of Physiology
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• 제15권2호
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• pp.73-81
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• 1981

Experiments were conducted in ischemic decerebrate cats to study the effects of electroacupuncture and electrical stimulation of peripheral nerve on pain reaction. Flexion reflex was used as an index of pain. The reflex was elicited by stimulating the sural nerve(20 V, 0.5 msec duration) and recorded as a compound action potential from the nerve innervated to the semitendinosus muscle. Electroacupuncture was performed, using a 23-gauge hyperdermic needle, on the tsusanli point in the lateral upper tibia of the ipsilateral hindlimb. The common peroneal nerve was selected as a peripheral nerve which may be associated with electroacupuncture action, as it runs through the tissue portion under the tsusanli point. Both for electroacupuncture and the stimulation of common peroneal nerve a stimulus of 20 V-intensity, 2 msec-duration and 2 Hz-frequency was applied for 60 min. The results are summerized as follows: 1) The electroacupuncture markedly depressed the flexion reflex; this effect was eliminated by systemic application of naloxone $(0.02{\sim}0.12\;mg/kg)$, a specific narcotic antagonist. 2) Similarly, the electrical stimulation of the common peroneal nerve significantly depressed the flexion reflex, the effect being reversed by naloxone. 3) When most of the afferent nerves excluding sural nerve in the ipsilateral hindlimb were cut, the effect of electroacupuncture on the flexion reflex was not observed. Whereas direct stimulation of the common peroneal nerve at the proximal end from the cut resulted in a significant reduction of the flexion reflex, again the effect was reversible by naloxone application. 4) Transection of the spinal cord at the thoracic 12 did not eliminate the effect of peripheral nerve stimulation on the flexion reflex and its reversal by naloxone, although the effect was significantly less than that in the animal with spinal cord intact. These results suggest that: 1) the analgesic effect of an electroacupuncture is directly mediated by the nervous system and involves morphine-like substances in CNS, 2) the site of analgesic action of electroacupuncture resides mainly in the brainstem and in part in the spinal cord.

• The Korean Journal of Pain
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• 제33권1호
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• pp.48-53
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• 2020

Background: The aim of this study was to clarify the topographical relationship between the accessory nerve (AN) and transverse cervical artery (TCA) to provide safe and convenient injection points for AN blockade. Methods: This study included 21 and 30 shoulders of 14 embalmed Korean adult cadavers and 15 patients, respectively, for dissection and ultrasound (US) examination. Results: The courses of the TCA and AN in the scapular region were classified into four types based on their positional relationships. Type A indicated the nerve that was medial to the artery and ran parallel without changing its location (38%). In type B (38%), the nerve was lateral to the artery and ran parallel without changing its location. In type C (19%), the nerve or artery traversed each other only once during the whole course. In type D (5%), the nerve or artery traversed each other more than twice forming a twist. At the levels of lines I-IV, the nerve was relatively close to the artery (approximately 10 mm). TCAs were observed in all specimens around the superior angle of the scapula at the level of line II, whereas they were not found below line VI. In US images of the patients, the TCA was commonly observed at the level of line II (93.3%) where all ANs and TCAs were observed in cadaveric dissection. Conclusions: The results expand the current knowledge of the relation between the AN and TCA, and provide helpful information for selective diagnostic nerve blocks in the scapular region.

• 대한두경부종양학회지
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• 제16권1호
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• pp.69-72
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• 2000

The neurilemmoma is a relatively uncommon benign neoplasm which is known to be originated from the schwann sheath of the nerve fiber. Parapharyngeal neurilemmomas may originate from any nerve traversing this space, but the vast majority arise from the vagus nerve and sympathetic chain. The neurilemmomas arising from the extracranial portion of the hypoglossal nerve are extremely rare. To our knowledge, the case we present is the ninth one to be reported occurring in the parapharyngeal space. Recently we experienced a case of parapharyngeal neurilemmoma arising from the hypoglossal nerve and so we report our case with a brief review of literatures.

• 대한두경부종양학회지
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• 제18권2호
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• pp.207-210
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• 2002

Schwannoma is a relatively rare benign tumor which may occur from nerve sheath of the peripheral, sympathetic and cranial nerves and so on except optic and olfactory nerves which have no nerve sheath themselves. Although it occur most frequently in the head and neck region especially in the acoustic nerve, the schwannoma originated from the motor nerves including hypoglossal nerve is very rare. Recently, we have experienced a case of schwannoma originated from hypoglossal nerve in a 47-year-old female. We report this case with literature review.

• 대한족부족관절학회지
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• 제9권2호
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• pp.227-230
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• 2005

Injuries to sural nerve through surgical incision or open wound in calcaneal fractures were reported as complications causing lateral hindfoot pain. But sural nerve entrapment by adhesive fibrous tissue after Essex-Lopresti axial fixation has not been reported. We report a case of sural nerve entrapment after Essex-Lopresti axial fixation which was successfully treated by nerve decompression.

• 대한두경부종양학회지
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• 제33권2호
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• pp.35-38
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• 2017

Neurilemmomas are benign tumors originating from Schwann cells, and may occur in various nerves; however, they rarely originate from the lingual nerve. When a lingual nerve neurilemmoma develops in the submandibular space, it can be challenging to diagnose it preoperatively, and this tumor can be misdiagnosed as a usual submandibular gland tumor owing to the rarity and a lack of knowledge about lingual nerve neurilemmomas. Therefore, it is important to consider neurilemmoma in the differential diagnosis in cases where the characteristics of the tumor do not correspond with the typical findings of submandibular gland tumors, in order to avoid inadvertent sacrifice of the nerve because of incorrect diagnosis of a salivary gland tumor. Herein, we report a lingual nerve neurilemmoma in the submandibular space, along with a literature review, to highlight the clinical significance and improve understanding of this type of tumor.