• Archives of Plastic Surgery
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• 제35권6호
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• pp.675-679
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• 2008

Purpose: In the orbital floor fracture, sensory impairment due to the damage of the infraorbital nerve is one of the most common symptom and complication. In this report, we have the assumption that tailoring of $medpor^{(R)}$ for decompression may have correlations to the damage and regeneration of the nerve. Methods: Among patients who had open reduction for pure orbital floor fracture in our hospital from March 2005 to March 2008, we selected 80 cases. In 40 cases, we inserted tailored $medpor^{(R)}$, and in other 40 cases, non-tailored $medpor^{(R)}$ was inserted. Patient's reports were obtained and analyzed, and the pin-prick test and the 2-point discrimination test on the infraorbital nerve regions were done for testing the sensory impairments. Results: The results show that the patients who adopted sculpture of $medpor^{(R)}$ showed higher tendency of recovery of sensory impairments in the patient's subjective report, static touch sensation, static two point discrimination using. And in postoperative 3 months, there are statistically significant recovery of sensory symptoms, signs and the result of sensory tests. Conclusion: From these results, tailored $medpor^{(R)}$ in reconstruction of orbital wall fracture may improve recovery of sensory impairments for decreasing of compression of infraorbital nerve.

• Clinics in Shoulder and Elbow
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• 제25권4호
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• pp.339-346
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• 2022

Rotator cuff tear is the most common cause of shoulder pain in middle-age and older people. Arthroscopic rotator cuff repair (ARCR) is the most common treatment method for rotator cuff tear. Early postoperative pain after ARCR is the primary concern for surgeons and patients and can affect postoperative rehabilitation, satisfaction, recovery, and hospital day. There are numerous methods for controlling postoperative pain including patient-controlled analgesia, opioid, interscalene block, and local anesthesia. Regional blocks including interscalene nerve block, suprascapular nerve block, and axillary nerve block have been successfully and commonly used. There is no difference between interscalene brachial plexus block (ISB) and suprascapular nerve block (SSNB) in pain control and opioid consumption. However, SSNB has fewer complications and can be more easily applied than ISB. Combination of axillary nerve block with SSNB has a stronger analgesic effect than SSNB alone. These regional blocks can be helpful for postoperative pain control within 48 hours after ARCR surgery.

• 한방재활의학과학회지
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• 제23권2호
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• pp.33-48
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• 2013

Objectives : Peripheral nerve injuries are commonly encountered clinical problems and often result in severe functional deficits. Sukjiyanggeun-Tang(shudiyangjin-tang), in oriental medicine, has been used to treat various musculoskeletal disorders. Methods : In the present study, the effects of aqueous extract of Sukjiyanggeun-Tang(shudiyangjin-tang) on functional recovery, severity of pain, and expressions of neurofilament, cycloxygenease-2(COX-2), inducible nitric oxide synthase(iNOS), and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$) following sciatic crushed nerve injury in rats were investigated. For this study, walking tract analysis, plantar test, western blot analysis for COX-2 iNOS, and TNF-${\alpha}$, and Immunofluorescence test for neurofilament were performed. Results : In the present results, sciatic functional index(SFI) in walking tract analysis was significantly decreased following sciatic crushed nerve injury, and pain severity in plantar test was significantly increased. COX-2, iNOS and TNF-${\alpha}$ expressions were increased whereas neurofilament expression was decreased by sciatic crushed nerve injury, In contrast, treatment with Sukjiyanggeun-Tang(shudiyangjin-tang) improved SFI in walking tract analysis and suppressed the pain severity in sciatic crushed nerve injury. Sukjiyanggeun-Tang(shudiyangjin-tang) treatment also suppressed COX-2, iNOS, and TNF-${\alpha}$ expressions and enhanced the neurofilament expression in sciatic crushed nerve injury. Conclusions : In the present study, we have shown that Sukjiyanggeun-Tang(shudiyangjin-tang) is the effective therapeutic modality to ameliorate the symptoms of sciatic crushed nerve injury.

• 한방재활의학과학회지
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• 제23권2호
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• pp.17-31
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• 2013

Objectives : Peripheral nerve injuries are commonly encountered clinical problems and often result in serve functional deficit. Bee venom and scolopendra subspinipes have been traditionally used in oriental medicine to treat several inflammatory diseases and chronic pain conditions. Methods : In the present study, the effects of bee venom pharmacopuncture and scolopendra subspinipes pharmacopuncture on functional recovery, severity of pain, and expressions of neurofilament, cycloxygenease-2(COX-2), and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$) following sciatic crushed nerve injury in rats were investigated. For this study, walking tract analysis, plantar test, western blot for COX-2 and TNF-${\alpha}$, and immunohistochemistry for neurofilament were performed. Results : In the present results, sciatic functional index(SFI) in walking tract analysis was significantly decreased following sciatic crushed nerve injury, and pain severity in plantar test was significantly increased. COX-2 and TNF-${\alpha}$ expressions were increased whereas neurofilament expression was decreased by sciatic crushed nerve injury. On the other hand, bee venom pharmacopuncture and scolopendra subspinipes pharmacopuncture improved SFI in walking tract analysis and suppressed the pain severity in sciatic crushed nerve injury. Bee venom pharmacopuncture and scolopendra subspinipes pharmacopuncture suppressed COX-2 and TNF-${\alpha}$ expression and enhanced the neurofilament expression in sciatic crushed nerve injury. Conclusions : In the present study, we have shown that treatment with bee venom or scolopendra subspinipes is the effective therapeutic modality to ameliorate the symptoms of sciatic crushed nerve injury. The efficacies of bee venom and scolopendra subspinipes were similar.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권3호
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• pp.239-247
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• 2005

This study demonstrated that xenogenic human marrow mesenchymal stem cells (hMSCs) could elicit the regeneration of the sensory nerve after axotomy in the adult rats infraorbital nerves without immunosuppression. For this, we evaluated the behavioral testing for functional recovery of the nerve and histological findings at weeks 3 and 5 compared to controls. Xenogenic hMSCs did not evoke any significant inflammatory or immunologic reaction after systemic and local administrations. HMSCs-treated rats exhibited significant improvement on sensory recovery tested with von Frey monofilaments. At 5 postoperative weeks, in the hMSCs treated nerve, expression of myelin basic protein (MBP), neurofilament (NF) at the site of axotomy was higher than control. And mRNA expression of neurotropin receptor Trk precursor (TrkPre), nerve growth factor receptor (NGFR) and neuropeptide (NPY) in trigeminal ganglion were also higher. The number of myelinated nerve at distal stump and cells in trigeminal ganglion were higher in hMSC treated rats. So it was supposed that transplanted MSCs contributed to reducing post-traumatic degeneration and production of neurotrophic factors. Immunofluorescence labeling showed small portion of hMSCs (<10%) expressed a phenotypic marker of Schwann cell (S-100). Xenogenic or allogenic mesenchymal stem cells might have immune privileged characteristics and useful tool for cell based nerve repair.

• 한국콘텐츠학회논문지
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• 제9권6호
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• pp.187-195
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• 2009

본 연구는 흰쥐를 대상으로 좌골신경 압좌 손상 유발 후 경피신경전기자극과 전침자극을 적용하고 진통효과와 기능회복에 미치는 영향을 알아보았다. 실험동물은 경피신경전기자극군을 적용한 TENS군, 전침자극군을 적용한 EA군과 대조군으로 구분하였고, 각각의 군은 전기자극 적용기간에 따라 1일군, 7일군 및 14일군으로 나누었다. 경피신경자극과 전침자극을 적용한 결과, 실험군에서 대조군에 비하여 통각신경활성의 지표로 이용되는 c-fos 발현의 감소, 발도피지연시의 증가, 좌골신경기능지수의 증가를 통해 전기자극이 말초신경 손상에서 통증억제와 기능회복을 증가시키는 것으로 나타났다. 하지만 경피신경전기자극군과 전침자극군간의 유의한 차이는 관찰되지 않았다.

• Archives of Reconstructive Microsurgery
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• 제19권2호
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• pp.93-96
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• 2010

We report a case of 44 years old male patient with neuroma-in-continuity of ulna nerve. In the patient's past history, he had received operative treatment for the open supracondylar fracture of right distal humerus and ulnar nerve injury at 10 years ago, and neurolysis was tried 2 times due to severe neuropathic pain. Despite of these operations, the symptom was not improved. In operative field, we noticed neuroma-in-continuity and decided to resect the neuroma until normal nerve fascicle was noted. The nerve cable graft was done with auto sural nerve on the defect site and the nerve was wrapped with small saphenous vein. At post operative 7 months, pain was markedly decreased and sensory recovery was slightly improved and patient was satisfied with the result.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권3호
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• pp.276-280
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• 2011

BSSRO (bilateral sagittal split ramus osteotomy) is an effective surgical method for maxillofacial deformities. Rigid fixation using a plate and screws can stabilize bony segments and induce early mouth opening. Though this procedure has a low complication rate, normal function and esthetic recovery is achieved through proper and early management of the complications. Complications consisting of temporomandibular disorders, sensory disturbances due to inferior alveolar nerve damage, open bite, malunion or nonunion, and facial nerve palsy occur, but these rarely develop. Facial nerve palsy causes the muscles involved in facial expression to depress, which results in ocular dryness or retinal damage. When facial nerve palsy develops, early management involving steroid medication and physical therapy is effective. In the case of severe damage, surgical intervention should be considered. A 20-year-male patient came to the oral and maxillofacial surgery department for orthognathic surgery. The mandible was set back by BSSRO under general anesthesia. Facial nerve palsy was observed on the left side of the face: steroid and vitamins were administered early and physical therapy was performed daily. These forms of management can aid in function and allow for gradual esthetic recovery. Presumed causes were excessive soft tissue retraction or soft tissue injury by the osteotome at the horizontal osteotomy of the ramus. Careful dissection, retraction and a precise osteotomy are needed for protection of the facial nerve. If nerve damage is observed, early management can help in the recovery of facial nerve function and esthetics.

• 대한두개안면성형외과학회지
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• 제21권6호
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• pp.337-344
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• 2020

Facial paralysis is a devastating disease, the treatment of which is challenging. The use of the masseteric nerve in facial reanimation has become increasingly popular and has been applied to an expanded range of clinical scenarios. However, appropriate selection of the motor nerve and reanimation method is vital for successful facial reanimation. In this literature review on facial reanimation and the masseter nerve, we summarize and compare various reanimation methods using the masseter nerve. The masseter nerve can be used for direct coaptation with the paralyzed facial nerve for temporary motor input during cross-facial nerve graft regeneration and for double innervation with the contralateral facial nerve. The masseter nerve is favorable because of its proximity to the facial nerve, limited donor site morbidity, and rapid functional recovery. Masseter nerve transfer usually leads to improved symmetry and oral commissure excursion due to robust motor input. However, the lack of a spontaneous, effortless smile is a significant concern with the use of the masseter nerve. A thorough understanding of the advantages and disadvantages of the use of the masseter nerve, along with careful patient selection, can expand its use in clinical scenarios and improve the outcomes of facial reanimation surgery.

• Journal of Oral Medicine and Pain
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• 제34권4호
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• pp.379-385
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• 2009

하악신경은 삼차신경의 한 분지로 발치, 임플란트 수술 등의 치과치료에 의하여 손상이 유발될 수 있으며, 다양한 신경병증을 보일 수 있다. 본 연구의 목적은 하악신경 손상 후 발생한 감각부전 환자들에 대한 분석을 통하여 감각부전의 이해에 필요한 기초 자료를 제시하고 의미를 파악해 보는 것이다. 2007년 1월부터 2009년 7월까지 하악신경 손상에 의한 감각부전으로 진단받은 환자 59명의 의무기록을 분석하여 다음과 같은 결과를 얻었다. 1. 가장 빈번한 손상 원인은 임플란트 수술에 의한 손상(59%)이었고, 가장 빈번한 손상 분지는 하치조신경(81%)이었다. 2. 신경 손상이 발생한 후 경과한 기간이 6개월 이상인 경우, 6개월 미만인 경우에 비하여 통증 강도(Visual Analogue Scale; VAS)가 4.82에서 6.91로 유의하게 증가해 있었다. 3. 약물치료 등 보존적 치료를 시작한 시기에 따른 감각부전의 회복 정도는 조기에 치료를 시작한 경우 증상의 회복을 보인 환자의 비율이 증가하는 경향을 보였으나, 통계학적으로 유의한 상관관계를 나타내지는 않았다. 4. 전산화단층촬영 영상에서 하치조신경관의 침범 수준에 따라 통증 강도나 감각부전의 회복 정도는 통계학적으로 유의한 상관관계를 나타내지 않았다. 결론적으로, 하악신경의 감각부전 환자들에서 치과 임플란트로 인한 하치조신경 손상이 가장 많은 비중을 차지하고 있었다. 하치조신경에 대한 침범 수준이 감각부전을 유발하는 가장 중요한 요인이겠지만 환자가 느끼는 주관적인 통증 강도나 치료에 대한 반응 등에는 신경의 손상 정도 이외에도 통증에 대한 환자의 반응, 심리상태, 치료의 시작 시기 등 많은 요인의 영향이 있을 것으로 생각된다. 따라서 조기에 약물치료 등 적극적인 보존적 치료를 시작하는 것이 증상의 회복을 위해 바람직할 것으로 생각된다. 또한 전산화단층촬영 영상에서 신경관을 직접 침범하지 않고, 신경관에 근접한 경우에도 감각부전이 나타난 경우가 적지 않은 것으로 보아 임플란트 수술 시 감각 부전의 방지를 위하여 충분한 안전거리 확보가 필수적일 것으로 사료된다.