• 대한두개안면성형외과학회지
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• 제25권1호
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• pp.1-10
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• 2024

The facial nerve stimulates the muscles of facial expression and the parasympathetic nerves of the face. Consequently, facial nerve paralysis can lead to facial asymmetry, deformation, and functional impairment. Facial nerve palsy is most commonly idiopathic, as with Bell palsy, but it can also result from a tumor or trauma. In this article, we discuss traumatic facial nerve injury. To identify the cause of the injury, it is important to first determine its location. The location and extent of the damage inform the treatment method, with options including primary repair, nerve graft, cross-face nerve graft, nerve crossover, and muscle transfer. Intracranial proximal facial nerve injuries present a challenge to surgical approaches due to the complexity of the temporal bone. Surgical intervention in these cases requires a collaborative approach between neurosurgery and otolaryngology, and nerve repair or grafting is difficult. This article describes the treatment of peripheral facial nerve injury. Primary repair generally offers the best prognosis. If primary repair is not feasible within 6 months of injury, nerve grafting should be attempted, and if more than 12 months have elapsed, functional muscle transfer should be performed. If the affected nerve cannot be utilized at that time, the contralateral facial nerve, ipsilateral masseter nerve, or hypoglossal nerve can serve as the donor nerve. Other accompanying symptoms, such as lagophthalmos or midface ptosis, must also be considered for the successful treatment of facial nerve injury.

• Journal of Trauma and Injury
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• 제21권1호
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• pp.66-69
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• 2008

Traumatic bilateral abducens nerve palsy is rare and is associated with intracranial, skull and cervical spine injuries. We report a case of bilateral abducens nerve palsy in a 40-month-old patient with a skull base fracture. The injury mechanism was associated with direct nerve injury caused by a right petrous bone fracture and indirect injury by frontal impact on the abducens nerve at the point of fixation to the petrous portion and Dorello's canal. The emergency physician should be aware of injuries and the mechanism of abducens nerve palsy in head trauma.

• Archives of Plastic Surgery
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• 제46권2호
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• pp.171-175
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• 2019

Forearm fractures are common injuries in childhood. Median nerve entrapment is a rare complication of forearm fractures, but several cases have been reported in the literature. This case report discusses the diagnosis and management of median nerve entrapment in a 13-year-old male who presented acutely with a both-bone forearm fracture and numbness in the median nerve distribution. Following the delayed diagnosis, surgical exploration revealed complete nerve entrapment and a nerve graft was performed.

• Journal of Korean Neurosurgical Society
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• 제51권5호
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• pp.305-307
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• 2012

Oblique basal skull fractures resulting from lateral crushing injuries involving both clivus and occipital condyle are rare due to their deep locations. Furthermore, these fractures may present clinically with multiple cranial nerve injuries because neural exit routes are restricted in this intricate region. The authors present an interesting case of basal skull fractures involving the clivus and occipital condyle and presenting with sixth and contralateral twelfth cranial nerve deficits. Clinico-anatomic correlations and the courses of cranial nerve deficits are reiterated. To the authors' knowledge, no other report has been previously issued on concomitant sixth and contralateral twelfth cranial nerve palsies following closed head injury.

• Archives of Hand and Microsurgery
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• 제23권4호
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• pp.306-312
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• 2018

안면 신경의 측두지는 그 해부학적 위치로 인하여 외상성 손상에 취약하며, 이로 인해 환자는 종종 상당한 미용적, 기능적 손실을 경험한다. 나아가 결손이 있는 만성 손상은 신경 이식 등의 추가적인 시술이 필요한 경우가 많기에 급성 손상에 비하여 그 치료가 까다롭다. 본 연구에서는 안면 신경의 측두지 손상 발생으로부터 1개월 후에 지연된 신경 이식을 한 남성 환자의 증례를 다루었다. 우리는 성공적으로 비복 신경을 분할 이식하였으며 환자는 양호한 미용적, 기능적 회복을 보였다.

• Journal of Trauma and Injury
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• 제27권3호
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• pp.79-83
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• 2014

The brachial plexus is a network of nerves that provides movement and feeling to the shoulder, arm and hand. The majority of acute brachial plexus injuries occur when the plexus is stretched violently or torn. This happens as result of the shoulder being pressed down forcefully while the head is pushed up and away from that shoulder. Such injuries frequently result from automobile or motor-cycle accidents or from falls and usually affect one side. Nerve injuries vary in severity from a mild stretching of the nerve to a tearing of the nerve root away from the spinal cord. We experienced a 50-year-old woman with weakness in both upper extremities after an attempted hanging. A consecutive workup revealed bilateral brachial plexus injuries. Six months after the incident, she had fully recovered. This is a very rare case of bilateral brachial plexus injuries after an attempted hanging.

• Journal of Trauma and Injury
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• 제34권4호
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• pp.257-262
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• 2021

Purpose: Pediatric hand trauma is common and sometimes causes deformity or disability. The incidence and etiologies of hand trauma in children are different from those in adults. This study analyzed the characteristics of pediatric hand trauma cases and patients over a 15-year period. Methods: We conducted a retrospective medical record review of 3,432 children (2,265 boys, 1,167 girls, under 18 years of age) with hand injuries from January 2005 to December 2019. We evaluated the sex distribution and injury etiologies. Injuries were classified by type as burns, amputations, crushing injuries, lacerations, extensor and flexor tendon injuries, open and closed fractures, and nerve injuries. Results: Among the pediatric hand injury patients, males were predominant (1.94:1). Simple lacerations (58.4%) were the most common injury type, followed by fractures (22.8%). Lacerations and burns tended to be common in younger age groups, while tendon injuries, nerve injuries, and crushing injuries were more frequently encountered in older age groups. Conclusions: Hand trauma prevention strategies should be established considering the frequent trauma etiologies in specific age groups. An awareness of age-specific characteristics of pediatric hand trauma patients will be helpful to prevent hand trauma.

• Journal of Chest Surgery
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• 제55권6호
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• pp.462-469
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• 2022

Background: Carotid endarterectomy (CEA) is used to treat carotid stenosis, which is associated with cerebral infarction and may result in neurologic deficits such as stroke, transient ischemic attack (TIA), and local nerve injury. To decrease surgery-related complications and improve patient satisfaction with esthetic outcomes, efforts have been made to minimize incision size instead of using a standard longitudinal incision. Methods: We performed a retrospective analysis of 151 cases of CEA, of which 110 used conventional incisions and 41 used high mini-skin incisions (HMIs), from March 2015 to December 2021 at a single institution. Short-term (30-day) postoperative results were evaluated for rates of mortality, stroke, TIA, and cranial/cervical nerve injuries. Risk factors for nerve injury were also assessed. Results: The HMI group showed significantly (p<0.01) shorter operative and clamp times than the conventional group. The HMI group also had significantly shorter incision lengths (5.3±0.9 cm) than the conventional group (11.5±2.8 cm). The rates of stroke, TIA, and death at 30 days were not significantly different between the 2 groups. There was no significant difference in the rate of cranial and cervical nerve injuries, and all injuries were transient. A high lesion level (odds ratio [OR], 9.56; 95% confidence interval [CI], 3.21-28.42; p<0.01) and the clamp time (OR, 1.07; 95% CI, 1.03-1.12; p<0.01) were found to be risk factors for nerve injuries. Conclusion: Use of the HMI in CEA for carotid stenosis was advantageous for its shorter operative time, shorter internal carotid artery clamp time, reduced neurologic complications, and improved esthetics.

• 대한치과마취과학회지
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• 제14권2호
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• pp.89-94
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• 2014

Local anesthesia known as the safe and essential procedure to control pain in dentistry may cause sensory changes such as paresthesia or altered taste at the affected sites after even successful local anesthesia. Although the prognosis of the nerve injuries after local anesthesia is favorable, it might cause prolonged problems such as dysesthesia. The lingual nerve is a single fascicle at the level of the lingual among 1/3 of patients and more movable during regeneration compared to the inferior alveolar nerve after the injury. As a result, the lingual nerve is more vulnerable and has poorer outcomes. More vigilant clinical considerations are required to the lingual nerve injury after local anesthesia. Generally, more than 80% of cases are spontaneously resolved within 2 weeks after the local anesthesia even without any specific treatment. However, the patient having long lasting abnormal sensations more than 2 weeks needs specialists' care for further assessment. In case of dysesthesia which is a symptom of neuropathic pain, immediate referral to specialists is mandatory. The exact mechanism, how to prevent its occurrence, or specific treatments of the nerve injury related to the local anesthesia have not been elucidated. To prepare clinical or medicolegal problems, many cautious considerations are given to the patients who complain sensory changes after local anesthesia.

• 대한족부족관절학회지
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• 제10권2호
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• pp.247-249
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• 2006

Purpose: The neural injuries by the sprain around the ankle joint may contribute the chronic pain. Authors analyzed the incidence and the contributing factor of the neural injuries in ankle sprain. Materials and Methods: 52 patients (54 cases) were involved in this retrospective study. Patient with diabetes or spinal disease were excluded. Plain radiograph and MR image were evaluated. Treatments were consisted of cast immobilization for 4 weeks with weight bearing ambulation following bracing for 8 weeks. Neurologic evaluation were performed at 3 months, 6 months, 12 months post-injury period and each neural injury were confirmed by electromyography or lidocaine block test. Results: The average age was 39 years old and 34 cases were male and 20 cases were female. Rupture of the anterior talofibular ligament was observed in 48 cases, distal anterior tibiofibular ligament in 37 cases, calcaneofibular ligament in 6 cases. One cases revealed no injury of the ligament. Neural injuries around ankle was observed in 13 cases ; superficial peroneal nerve in 9 cases, sural nerve in 5 cases, saphanous nerve in 1 case. Neural injury was not influenced by the degree of ligament injuries but by the incidence numbers of ankle sprain. All cases were treated conservatively and symptom was subsided in all but 2 cases. Conclusion : Although the incidence is relatively low, the neural injuries in ankle sprain may occur in the recurrent ankle sprain and conservative treatment for neural injuries is satisfactory.