• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권3호
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• pp.447-457
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• 1994

Authors have studied retrospectively the facial nerve injury after TMJ surgery through the preauricular approach routine. The study material used was 4 patients of all 113 patients who were diagnosed as internal derangement and have been operated from March 1989 to February 1991 in Youngdong severance hospital, and were induced postoperatived facial nerve injury. The patient group who had the postoperative injured facial nerve was recognized degree of injury using the diagnostic method, Electromyography(EMG) and Nerve conduction test(NCT) which are used widely at present and was treated as conservative care and we identified the recovery time as the same method. The results as follows : 1. The meticulous care and precious surgical technique are needed in both operation and postoperation. During the TMJ surgery, the excessive retraction of the flap and frequent use of nerve stimulator and electric surgical knife should be avoided as possible and postoperative hematoma and swelling should be minimized. 2. The 4 patients were experienced with the postoperative facial nerve injury of all 133 patients who had been operated the TMJ surgery through the routine preauricular approach on our hospital. And the incidence of postoperative facial nerve injury happened was about 0.3% and its incidence was relatively low comparing with any other previous reports. 3. EMG and NCT were considered as useful methods which can diagnose the nerve injury objectively and identified the effect of treatment and recovery time. 4. The faical nerve-injured patients who were induced postoperatively after TMJ surgery, were diagnosed as second-degree nere injury through the EMG and NCT. And the patient group was treated well as conservative physical therapy for about 2 to 4 months.

• Journal of Chest Surgery
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• 제54권6호
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• pp.535-538
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• 2021

Schwannomas are rare benign tumors that develop in Schwann cells lining peripheral nerves. Schwannomas of the brachial plexus are especially rare, accounting for 5% of all cases. Although several treatments can be considered, the exact method of treatment is unclear owing to the scarcity and sporadic occurrence of schwannomas. Tumor resection is performed in most cases, and nerve damage is inevitable in cases of neuroinvasive schwannoma. In this case series, we present our successful use of transposition of cable-grafted nerves for the treatment of schwannomas. We performed cable-grafted nerve interposition in addition to tumor resection, leading to increased recovery of nerve damage. To relieve postoperative symptoms and minimize sequelae, precise surgical tumor resection followed by nerve interposition using a cable-grafted nerve may be recommended.

• 대한족부족관절학회지
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• 제3권1호
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• pp.5-11
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• 1999

We present our experience with the use of nerve block anesthesia in 212 of 484(43.8% ) surgical procedures of the foot and ankle between 1995 and 1997. Nerve block anesthesia was used for surgical procedures of the forefoot, midfoot, hindfoot, and ankle in the setting of elective surgery and trauma. From the viewpoint of the surgeon, nerve block anesthesia was completely successful in 99.5% of the procedures performed. We confirmed that 80% of patients were satisfied with the use of nerve block anesthesia for their operative procedure. There were only one(0.5%) miner complication being toxic neuritis of posterior tibial nerve. With increasing experience, the expanded indications and uses of nerve block anesthesia for foot and ankle surgery are proving to be simple, safe, reliable, and well tolerated by the patient.

• 대한정형외과 초음파학회지
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• 제3권2호
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• pp.74-78
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• 2010

정형외과 영역에서 근골격계 초음파의 활용 범위가 넓어짐에 따라 슬와부 신경 차단(좌골 신경 차단)이나 대퇴 신경 차단(또는 복재 신경 차단)이 초음파를 이용하여 신경 손상이나 불완전 마취에 대한 걱정없이 쉽고, 안전하게 시행될 수 있게 되었다. 그로 인하여 족부 수술 뿐만 아니라 족관절 및 하퇴부의 정형외과적 수술이 전신 마취나 척추 마취의 부담없이 시행될 수 있게 되었다. 이러한 초음파 유도 대퇴좌골 신경 차단에 대한 자세한 술기를 120예 이상의 경험을 바탕으로 보고하고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권2호
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• pp.261-268
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• 1996

An experimental study was performed to evaluate the efficacy of nerve growth factor(NGF) on inferior alveolar nerve in a rabbit model. In 20 New Zealand white rabbits, 14mm of bilat eral alveolar nerve were resected and the defects were repaired with the 17mm silicone conduits. In group I, 5mm autologous nerve segment were located centrally in the left side after tubulization and NGF solution(Sigma chemical 0.1 mg/mL) was instilled into each conduit. In group II, nerve repair modality was the same but no NGF solution was instilled into the conduits. On 2 months and 6 months postoperatively, the results were evaluated by clinical and hist omorphometric assessment. The result was that autologous nerve segment group show the best nerve regeneration effect and NGF instilled group the worst.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.40.1-40.7
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• 2019

Background: Through the analysis of clinical data, we attempted to investigate the etiology and determine the risk of severe iatrogenic lingual nerve injuries in the removal of the mandibular third molar. Methods: A retrospective chart review was performed for patients who had undergone microsurgical repair of lingual nerve injuries. The following data were collected and analyzed: patient sex, age, nerve injury side, type of impaction (Winter's classification, Pell and Gregory's classification). Ratios for the respective lingual nerve injury group data were compared with the ratios of the respective data for the control group, which consisted of data collected from the literature. The data for the control group included previous patients that encountered various complications during the removal of the mandibular third molar. Results: The lingual nerve injury group consisted of 24 males and 58 females. The rate of female patients with iatrogenic lingual nerve injuries was significantly higher than the control groups. Ages ranged from 15 to 67 years, with a mean age of 36.5 years old. Lingual nerve injury was significantly higher in the patient versus the control groups in age. The lingual nerve injury was on the right side in 46 and on the left side in 36 patients. There was no significant difference for the injury side. The distoangular and horizontal ratios were the highest in our lingual nerve injury group. The distoangular impaction rate in our lingual nerve injury group was significantly higher than the rate for the control groups. Conclusion: Distoangular impaction of the mandibular third molar in female patients in their 30s, 40s, and 50s may be a higher risk factor of severe lingual nerve injury in the removal of mandibular third molars.

• Archives of Reconstructive Microsurgery
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• 제19권1호
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• pp.50-55
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• 2010

Injury of the musculocutanous nerve can be associated with a proximal humeral fracture or shoulder dislocation, and injury of the brachial plexus. However, injury of this nerve associated with a humeral shaft fracture has rarely been reported. Diagnosis of the musculocutaneous nerve injury is difficult because its sensory loss is ill-defined, and examination of elbow flexion is difficult when it is associated with fractures. We report an unusual case of musculocutaneous nerve injury in a 27 years old woman who had multiple injuries including a humerus shaft fracture, an ipsilateral radius shaft fracture, and an associated radial nerve laceration. Diagnosis of the musculocutaneous nerve injury was delayed because combined fractures of the humerus and radius prevented proper examination of the elbow motion and nerve grafting of the radial nerve delayed early elbow motion exercise. Delayed exploration of the musculocutaneous nerve 6 months after trauma showed complete rupture of the nerve at its entry into the coracobrachialis muscle and the defect was successfully managed by sural nerve graft.

• Archives of Plastic Surgery
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• 제39권1호
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• pp.71-75
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• 2012

Recurrent laryngeal nerve paralysis is the most common and serious complication after thyroid cancer surgery. The objective of this study was to report the advantages of the vein wrapping technique for nerve reconstruction in patients with thyroid cancer invading the recurrent laryngeal nerve and its effects on postoperative phonatory function. The subjects were three patients who underwent resection of the recurrent laryngeal nerve during surgical extirpation of papillary thyroid cancer. Free ansa cervicalis nerve graft or direct neurorrhaphy with a vein wrapping technique was used to facilitate nerve regeneration, protect the anastomosed nerve site mechanically, and prevent neuroma formation. One-year postoperative laryngoscopic examination revealed good vocal cord mobility. Maximum phonation time ($19.5{\pm}0.3$ sec) was longer than a previously-reported value in conventional reconstruction patients ($18.8{\pm}6.6$ sec). The present phonation efficiency index ($7.88{\pm}0.78$) was higher than that previously calculated in conventional reconstruction ($7.59{\pm}2.82$). The mean value of the Voice Handicap Index-10 was 6, which was within the normal range. This study demonstrates improvement in phonation indices measured 1 year after recurrent laryngeal nerve reconstruction. Our results confirm that the vein wrapping technique has theoretical advantages and could be favored over conventional reconstruction techniques for invenerate nerve injuries.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제25권4호
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• pp.350-355
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• 1999

Purpose : The purpose of this study was 1) to find nerve damage after inferior alveolar nerve transposition and 2) to examine whether the soft tissue or bone changes around the nerve produce the compression to the nerve in the healing period. Materials and Method : Inferior alveolar nerve was exposed through the bony window and the scratch was made in the bone to be thought as the inferior alveolar canal. Suture was made after the nerve was repositioned. The nerve and surrounding tissues were examined with the light microscope and the fluorescent microscope before surgery and at 1 month, 3 months, and 5 months after surgery. Results : After surgery, the epineurium was damaged and the nerve was divided to several fascicles covered with the perineurium The newly formed fibrous connective tissue and vessels were seen around fascicles. There was new bone formation. However the nerve was not compressed by the connective tissue or the new bone. Conclusion : The results of this study suggest that neurosensory disturbances after inferior alveolar nerve transposition are resulted by the direct trauma in surgery rather than the compression to the nerve by the scar or new bone formation in the healing period.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권3호
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• pp.191-198
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• 2017

Background: For peripheral nerve regeneration, recent attentions have been paid to the nerve conduits made by tissue-engineering technique. Three major elements of tissue-engineering are cells, molecules, and scaffolds. Method: In this study, the attachments of nerve cells, including Schwann cells, on the nerve conduit and the effects of both growth factor and adhesion molecule on these attachments were investigated. Results: The attachment of rapidly-proliferating cells, C6 cells and HS683 cells, on nerve conduit was better than that of slowly-proliferating cells, PC12 cells and Schwann cells, however, the treatment of nerve growth factor improved the attachment of slowly-proliferating cells. In addition, the attachment of Schwann cells on nerve conduit coated with fibronectin was as good as that of Schwann cells treated with glial cell line-derived neurotrophic factor (GDNF). Conclusion: Growth factor changes nerve cell morphology and affects cell cycle time. And nerve growth factor or fibronectin treatment is indispensable for Schwann cell to be used for implantation in artificial nerve conduits.