• The Journal of Korean Medicine
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• v.27 no.4
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• pp.116-124
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• 2006

Peripheral nerve injuries are a commonly encountered clinical problem and often result in chronic pain and severe functional deficits. At the Dept. of Oriental Rehab. Medicine, we have used for pain control a herbal bath containing the following herbs: Harpagophytum radix, Atractylodes japonica and Corydalis tuber. In the present study, we investigated the effects of this herbal bath on the recovery rate of the locomotor function and the expression of c-Fos in the ventrolateral periaqueductal gray (vIPAG) region of the brain following sciatic crushed nerve injury in rats. In the present study, characteristic gait change with decreasing of the sciatic function index (SFI) was observed and c-Fos expression in the vIPAG was suppressed following sciatic crushed nerve injury in rats. Immersion into herbal bath enhanced SFI value and restored c-Fos expression in the vIPAG to the control value. These results suggest the herbal bath might activate neurons in the vIPAG, and could facilitate functional recovery from peripheral nerve injury.

• Journal of Oral Medicine and Pain
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• v.46 no.4
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• pp.136-142
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• 2021

Purpose: Oral and facial sensation is affected by various factors, including trauma and disease. This study assessed the clinical profile of patients diagnosed with sensory dysfunction and investigated their sensory perception using simple qualitative sensory tests. Methods: Based on a retrospective review of the medical records, we analyzed a total of 68 trigeminal nerve branches associated with sensory dysfunction in 52 subjects. We analyzed the frequency and etiology of sensory dysfunction, and the frequency of different types of sensory perception in response to qualitative sensory testing using tactile and pin-prick stimuli. Results: The inferior alveolar nerve branch was the most frequently involved in sensory dysfunction (88.5%). Third molar extraction (36.5%) and implant surgery (36.5%) were the most frequent etiological factors associated with sensory dysfunction. Hypoesthesia was the most frequent sensory response to tactile stimuli (60.3%). Pin-prick stimuli elicited hyperalgesia, hypoalgesia, and analgesia in 32.4%, 27.9%, and 36.8%, respectively. A significant association was found between the two kinds of stimuli (p=0.260). Conclusions: Sensory dysfunction frequently occurs in the branches of the trigeminal nerve, including the inferior alveolar nerve, mainly due to trauma associated with dental treatment. Simple qualitative sensory testing can be conveniently used to screen sensory dysfunction in patients with altered sensation involving oral and facial regions.

• Archives of Plastic Surgery
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• v.49 no.3
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• pp.440-443
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• 2022

Spinal accessory nerve (SAN) palsy is typically a result of posterior triangle surgery and can present with partial or complete paralysis of the trapezius muscle and severe shoulder dysfunction. We share an atypical case of a patient who presented with SAN palsy following an injury sustained playing competitive volleyball. A 19-year-old right hand dominant competitive volleyball player presented with right shoulder weakness, dyskinesia, and pain. She injured the right shoulder during a volleyball game 2 years prior when diving routinely for a ball. On physical examination she had weakness of shoulder shrug and a pronounced shift of the scapula when abducting or forward flexing her shoulder greater than 90 degrees. Manual stabilization of the scapula eliminated this shift, so we performed scapulopexy to stabilize the inferior angle of the scapula. At 6 months postoperative, she had full active range of motion of the shoulder. SAN palsy can occur following what would seem to be a routine volleyball maneuver. This could be due to a combination of muscle hypertrophy from intensive volleyball training and stretch sustained while diving for a ball. Despite delayed presentation and complete atrophy of the trapezius, a satisfactory outcome was achieved with scapulopexy.

• Journal of Korean Neurosurgical Society
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• v.46 no.2
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• pp.130-135
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• 2009

Objective: The purpose of this study was to determine the normal morphometric landmarks of the uniting and dividing points of the brachial plexus (BP) in the periclavicular region to provide useful guidance in surgery of BP injuries. Methods: A total of 20 brachial plexuses were obtained from 10 adult, formalin-fixed cadavers. Distances were measured on the basis of the Chassaignac tubercle (CT), and the most lateral margin of the BP (LMBP) crossing the superior and inferior edge of the clavicle. Results: LMBP was located within 25 mm medially from the midpoint in all subjects. In the supraclavicular region, the upper trunk uniting at 21$\pm$7 mm from the CT, separating into divisions at 42$\pm$5 mm from the CT, and dividing at 19$\pm$4 mm from the LMBP crossing the superior edge of the clavicle. In the infraclavicular region, the distance from the inferior edge of the clavicle to the musculocutaneous nerve (MCN) origin was 49$\pm$12 mm, to the median nerve origin 57$\pm$7 mm, and the ulnar nerve origin 48$\pm$6 mm. From the lateral margin of the pectoralis minor to the MCN origin the distance averaged 3.3$\pm$10 mm. Mean diameter of the MCN was 4.3$\pm$1.1 mm (range, 2.5-6.0) in males (n = 6), and 3.1$\pm$1.5 mm (range, 1.6-4.0) in females (n = 4). Conclusion: We hope these data will aid in understanding the anatomy of the BP and in planning surgical treatment in BP injuries.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.1
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• pp.81-85
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• 2009

As panfacial fractures are involved multiple fracture, there are possibility of many pre-operative & postoperative complications. It is necessary to do exact pre-operative evaluation, appropriate operation and care, for preventing and treating these complications, especially related to optic nerve injury. The complication occurs rarely after periorbital facial bone fracture, and indirect injuries may occur as a result of impact shearing force transmitted into the optic nerve axons or to the nutrient vessels of the optic nerve. Also indirect injuries may occur after the force of impact because of vasospasm and swelling of the optic nerve within the confines of the nonexpansile optic canal. It is necessary to active evaluation and treatments involving decompression of the orbit surgically and high dose steroid therapy in relation to panfacial fracture. But sometimes this treatments are limited due to severe swelling of the face and related multiple bone fractures in the body. This case showed the delayed neuropathy, at last visual loss, in spite of megadose methylprednisolone administration. The purpose of this article is to present indirect traumatic optic neuropathy that is one of many complications in panfacial bone fracture.

• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.128-136
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• 1996

Radial nerve injury is caused by variety of etiologies, mainly traumatic. It is primarily a motor nerve and loss of it's function leads to a significant disability. Surgical treatments of radial nerve comprise of neurolysis(internal or external), neurorrhaphy(eineural, perineural or epi-perineural), nerve graft and tendon transfer. However, there is still controversies in treatment methods and time of operation. Authors experienced 23 cases of radial nerve injuries who were treated by operative methods and followed up over 1 year's duration. The male to female ratio was 18 to 5 and mean age was 30.7 years old. The causes were 13 cases in fractures, 5 cases in crushing injury, 3 cases in laceration, 1 case in CO poisoning and 1 case in unknown cause. The summary of the study were as follows ; 1. Excellent or good results were obtained in overall 16 cases among 23 cases; 5 of 9 cases in neurolysis, 3 of 3 cases in neurorrhaphy, 2 of 3 cases in nerve graft and 6 of 8 cases in tendon transfer. 2. In cases of neurorrhaphy and nerve graft, primary or delayed repair showed excellent or good results and neurolysis performed before 6 months leads to better results. But there was no correlations between the time of injury and operation in tendon transfer. 3. The radial nerve injury associated with extensive soft tissue defect or any conditions that leads to nerve ischemia results poor prognosis. 4. The patients aged under 40 years showed better prognosis in clinical results according to the age of surgical treatment. 5. If the surgeon decide the method and the time of operation through the exact evaluation of the factors which influencing the end result such as age of the patient, level and type of injury, extent of nerve lesion and the associated tissue injury, good result could be expected.

• Imaging Science in Dentistry
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• v.52 no.3
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• pp.259-266
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• 2022

Purpose: This study aimed to evaluate the clinical usefulness of magnetic resonance (MR) neurography using the 3-dimensional double-echo steady-state with water excitation (3D-DESS-WE) sequence for the preoperative delineation of the facial and lingual nerves. Materials and Methods: Patients underwent MR neurography for a tumor in the parotid gland area or lingual neuropathy from January 2020 to December 2021 were reviewed. Preoperative MR neurography using the 3D-DESS-WE sequence was evaluated. The visibility of the facial nerve and lingual nerve was scored on a 5-point scale, with poor visibility as 1 point and excellent as 5 points. The facial nerve course relative to the tumor was identified as superficial, deep, or encased. This was compared to the actual nerve course identified during surgery. The operative findings in lingual nerve surgery were also described. Results: Ten patients with parotid tumors and 3 patients with lingual neuropathy were included. Among 10 parotid tumor patients, 8 were diagnosed with benign tumors and 2 with malignant tumors. The median facial nerve visibility score was 4.5 points. The distribution of scores was as follows: 5 points in 5 cases, 4 points in 1 case, 3 points in 2 cases, and 2 points in 2 cases. The lingual nerve continuity score in the affected area was lower than in the unaffected area in all 3 patients. The average visibility score of the lingual nerve was 2.67 on the affected side and 4 on the unaffected side. Conclusion: This study confirmed that the preoperative localization of the facial and lingual nerves using MR neurography with the 3D-DESS-WE sequence was feasible and contributed to surgical planning for the parotid area and lingual nerve.

• Journal of Korean Dental Science
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• v.6 no.2
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• pp.58-66
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• 2013

Purpose: The inferior alveolar nerve (IAN) can be damaged as a result of minor oral surgical procedure such as third molar extraction or implant placement. Repair of the injured IAN involves difficulty of access, and research studies are limited to elucidating the process of regeneration by surgical methods. This study sought to establish the rabbit animal model to apply polymeric membrane functionalized with nerve growth factor after a crush lesion for the evaluation of nerve regeneration using the electrophysiologic method. Materials and Methods: The IAN of 2 adult male New Zealand white rabbits (4 nerves) were exposed bilaterally, and crush injury rendered by jeweler's forceps was applied. Nerve conduction velocity was examined electrophysiologically using electromyography before, after, and 4 weeks after the crush injury. To evaluate the regeneration, the pattern of action potential of IAN was recorded, and the characteristics of neurons were histologically observed. Result: After the crush injury, afferent activity decreased in the injured group. Electromyography could not be recorded after four weeks because tissues surrounding the injured nerve collapsed. Decrease in the mean number of axons was observed in the injured part with membrane. Conclusion: Despite the limited result, the present animal model study may provide a possible way to research on the methods of enhancing the recovery of nerve injuries in clinical situations. For clinically widespread acceptance, however, it should gain more consecutive and scientific evidences.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.5
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• pp.415-423
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• 2005

Distraction osteogenesis (DO) is frequently used technique in reconstruction of bony defects resulted from tumor resection, congenital deformity, and trauma in the maxillofacial region. Although the histologic and ultrastructural changes associated with distraction osteogenesis have been extensively described, the exact changing of the surrounding tissues, such as nerve tissues, were still unclear. This study observed the histological changes and the expression of nerve growth factor (NGF) in the inferior alveolar nerve (IAN) after distraction osteogenesis. Unilateral mandibular distraction (0.5 mm twice per day for 10 days) was performed in eight mongrel dogs. Two animals were sacrificed at 7, 14, 28 and 56 days after completion of distraction, respectively. The distracted IAN and contralateral control nerve were harvested and processed for histological and innunohistochemical examinations. The signs of acute nerve injuries, such as demyelination and partial discontinuation of nerver fiber, were observed in the distracted IAN on 7 and 14 days after distraction. The initial remyelination and regeneration of distracted IAN were showed at 14 days after completion of distraction. At 56 days later, the histologic features of distracted IAN was similar to those of the normal control IAN. The expression of NGF was significantly increased in most distracted nerve tissues on 7, 14 and 28 days after distraction. On 56 days after distraction, the expression of NGF returned to the normal level. This study suggested that the acute IAN injury caused by mandibular distraction were mostly recovered during consolidation period. The NGF was seemed to be induced from Schwann cell and damaged nerve tissues, and it may have important roles in the initial healing of damaged nerves.

• Archives of Plastic Surgery
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• v.37 no.2
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• pp.105-109
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• 2010

Purpose: The purpose of this study is to determine the effect of platelet-rich plasma (PRP) on rat sciatic nerve regeneration in a 10 mm silicone chamber. Methods: A total of 6 inbred Lewis rats were used in this study. Bilateral sciatic neurectomy was performed on each rat. On one side, silicone chambers containing PRP solutions were implanted; on the contralateral side, the chambers without PRP were implanted as a control. In 12 weeks post-implantation, chambers were retrieved and both gastrocnemius muscles were excised. Nerves biopsy samples were examined under a light microscope after Masson trichrome staining. Results: Cross sections of the midpoints of PRP treated nerves were significantly larger and appeared more mature than those of controls. Conclusion: Based on morphological evidence, PRP has a positive effect on neural regeneration, and it may therefore be useful for treating peripheral nerve injuries.