• The Korean Journal of Pain
• /
• v.11 no.2
• /
• pp.326-331
• /
• 1998

Facial nerve paralysis is a common pain clinical diagnosis. But ipsilateral or contralateral recurrent facial paralysis is found in about 2.6~19.5% of facial paralysis and especially bilateral facial paralysis is rare. While idiopathic facial paralysis is the most common diagnosis, a comprehensive evaluation must be completed prior to this diagnosis in patients with bilateral facial paralysis. A representative case of bilateral alternating facial paralysis treated with stellate ganglion block (SGB) is presented. A 57 years old male patient who had the onset of a right facial paralysis 7 months ago visited pain clinic. Five months after the onset of right facial paralysis, as it was improving, he developed a left facial paralysis. He had history of hypertension, diabetus mellitus and pain episode on mastoid process before facial paralysis developed. Electrical test showed incomplete neuropathy on both side and computed tomography (CT) scan was normal. He was treated with SGB, physical theraphy and aspirin medication. After 25 times SGB, he was recovered almost completely.

• Clinical and Experimental Pediatrics
• /
• v.45 no.10
• /
• pp.1292-1298
• /
• 2002

Melkersson-Rosenthal syndrome(MRS) is a rare disorder, having a symptom triad of recurrent facial palsy, orofacial swelling and fissured tongue(lingua plicata). This disorder is usually recurrent or progressive, and monosymptomatic or oligosymptomatic forms have been reported to be more common than classic forms. Generally, MRS occurs in young adults at the end of the second decade of life and incidence of the disease in childhood is known to be very low. Although the clinical manifestation of MRS in children is similar to that in adults, early diagnosis and management is essential to avoid long-lasting functional disorders and psychological problems. We experienced MRS in a 13 year old boy with a history of recurrent facial palsy. We report this case with review of related literature.

• The Korean Journal of Pain
• /
• v.2 no.1
• /
• pp.57-60
• /
• 1989

The Melkersson-Rosenthal (M-R) syndrome consists of a triad of (1) recurrent peripheral facial nerve paralysis which develops alternately on both sides of face, (2) non-inflammatory facial edema, and (3) fissuring of tongue. A 59 years old female patient developed the left facial palsy on September, 1988. Right facial palsy developed continuously 2 months later after the spontaneous remission of left facial palsy. On February, 1989, we have found out M-R syndrome which accompanied with migraine type of intermittent headache, and hypertension in one attack of cerebral stroke several years ago, there were no diabetes mellitus, pulmonary tuberculosis and brain tumor in clinical studies. Although the causes of this syndrome were not noted, we performed the stellate ganglion block and transcutaneous electrical nerve stimulation for treatment of the palsy, but the clinical effectiveness of these were not satisfactory.

• Annals of Clinical Neurophysiology
• /
• v.9 no.1
• /
• pp.5-10
• /
• 2007

Background: Bell's palsy (BP) is a self-limited rapid onset facial palsy that is non-life-threatening and has a generally favorable prognosis. Facial paralysis can be caused by numerous conditions, all of which should be excluded before the diagnosis of BP is reached. The etiopathogenesis and clinical course of BP are uncertain. So we analyzed the epidemiology and clinical course of BP patients. Methods: The subjects include 100 cases of BP examined during the period of 18 months. Careful clinical history, neurologic examinations, laboratory tests, electrophysiologic studies, and brain imaging were performed. Follow-up examinations were done once a week during the first month and subsequently once a month until normal function was restored or for up to 3 months. Facial nerve function was assessed by House-Brackman (HB) facial nerve grading scale and electrophysiologic studies. Results: Except 13 recurrent BP patients, we analyzed 87 BP patients. Forty-four (50.6%) were men and 43(49.4%) were women and the mean age was 51.0(${\pm}16.6$) years. Three (3.4%) patients showed a familial tendency. The initial examination within 1 week after attack revealed 35.2% was below HB grade 4 and 64.8% was above grade 3. The associated symptoms are as follows; postauricular pain, increase tear flow, taste change, hyperacusis and drooling. The initial facial nerve conduction study and blink reflex within 1 week after attack showed abnormal findings in 12.6% and 100%, respectively. Brain MRI was performed in 59(67.8%) patients and showed abnormal enhancement of affected nerve in 57(96.6%). Follow-up examination showed that 78.2% of the patients partially improved within 4 weeks and completely improved within 3 months. Finally 80.5% of the total patients obtained normal function in 3 months. Conclusions: We report epidemiologic, clinical, electrophysiologic and radiologic characteristics of BP patients.

• The Journal of Korean Medicine
• /
• v.16 no.2 s.30
• /
• pp.9-16
• /
• 1995

Forty four patients with Bell's palsy were treated with acupuncture from onset and clinical observation was carried on from March 1994 through Feburary 1995. Acupuncture treatment was done 3 times per week and the acupuncture points were LI4 Hapkok, ST36 Choksamni, LI20 Yonghyang, BL2 Ch'anjuk, TE17 Yep'ung, ST4 Chich'ang, ST6 Hyopko, GV26 Sugu, CV24 Sungjang, GB14 Yangbaek and Ex-HN4 Oyo. They were inserted to a depth of 0.5 to 1.0 cm. After insertion, manipulation was carried on until the patients felt strong numbness or De Qi sensation induced by rotating or twisting needles. Through-needling in lengths varying from 2.0 to 3.5 cm was also applied from ST4 Chich'ang to ST6 Hyopko, from GV26 Sugu or CV24 Sungjang to ST4 Chich'ang and from GB14 Yangbaek to Ex-HN4 Oyo. The mean age was 39.3 and 63.6% of the patients were women, including one pregnant woman. There was no recurrent palsy in this study. By applying the House-Brackmann facial nerve grading scales, patients were evaluated weekly from the first treatment to judged recovery or the 7th week of the treatment. 86.4% of the patients were recovered completely within 7 weeks and the average healing period was 3.7 weeks.

• Archives of Plastic Surgery
• /
• v.32 no.2
• /
• pp.262-266
• /
• 2005

In some blepharochalasis patients, upper blepharoplasty alone is not satisfactory because of narrow distance between eyebrow and eyelash. On that occasion, eyebrow lift is advisable. There are many methods of classical eyebrow lift, such as direct excision, transblepharoplasty approach, anterior hairline technique, and so on. But they are not so effective, have a tendency to recur and also give rise to side effects; unacceptable scar, facial nerve palsy, sensory loss and hematoma, etc. Some patients who have prominent nasolabial folds, are reluctant to perform face lift procedure due to psychologic or economic burden. The authors performed the eyebrow lift procedure separately or simultaneously with face lift or forehead lift. After making 2 or 3 slit incisions, we passed absorbable suture material, 3-0 vicryl, through suborbicularis oculi fat layer. Then it was passed through subperiosteal plane and fixated to the temporalis fascia. When patients complain prominent nasolabial folds, malar fat pad was elevated also in the same manner. This methods is effective and has minimal complication such as facial nerve palsy, scar, sensory loss. Recurrent tendency was rarely observed during follow-up. Dimples were observed at slit incision sites but they disappeared within 2 or 3 weeks. Eyebrow lift and malar fat lift by absorbable suture elevation with subperiosteal dissection is a simple and less morbid. Because of its effectiveness and little side effect or complication, this procedure can be a useful method.

• Imaging Science in Dentistry
• /
• v.50 no.4
• /
• pp.347-351
• /
• 2020

Mastoid osteomas of the temporal bone are rare, benign, and usually asymptomatic tumors. However, depending on their size and extension, mastoid osteomas may cause facial palsy, a sensation of ear fullness, pressure-related pain, hearing loss, recurrent external ear infections, and chronic discharge. The etiology of mastoid osteomas is still unknown, but congenital, infectious, and traumatic factors have been proposed. Surgical treatment may be performed with minimal postoperative morbidity. In this article, the authors report a case of a 48-year-old woman seeking orthodontic treatment with an unusual retroauricular protruding mass, including the diagnostic process and differential diagnosis. This case supports the essential role of cone-beam computed tomography to analyze and identify the lesion as a mastoid osteoma.

• Journal of Convergence Korean Medicine
• /
• v.2 no.1
• /
• pp.13-22
• /
• 2021

Objectives: Atopic dermatitis (AD) is an easily recurrent inflammatory skin disease. Since AD has complex pathology, people have been investigating it on different aspects with various experimental models. One of them is in vivo model which has spontaneously developed AD-like skin lesions by various inducers. Methods: In this study, two kinds of mouse species were applied in the experiment; BALB/c and C57BL/6 mice. We compared features among the animal species making AD mouse model with protein allergen, ovalbumin. AD-like skin lesions were induced by ovalbumin on two kinds of scheme and were evaluated with the histological results and size of spleen which is a critical immunological organ. Also, we measured the level of immunoglobulin E in serum. In addition, we investigated the results of ovalbumin induced-AD-like skin lesions along with obesity. Results and Conclusion: We evaluated weight of organs and thickness of epidermis. These results suggest the possibility of the appropriate in vivo experimental model for AD or the comorbidity with obesity.

• Archives of Plastic Surgery
• /
• v.33 no.6
• /
• pp.764-768
• /
• 2006

Purpose: Parotid neoplasia are relatively frequent, representing approximately 3% of all tumors in the head and neck regions. But incomplete resection and misdiagnosis of parotid gland is followed by multiple tumor invasion, tumor recurrence, and other iatrogenic tumor formation. In patients undergoing parotidectomy for confirmed or suspected malignancy, the traditional or modified rhytidectomy incision may prove suboptimal because it does not easily lend itself to a continuous neck dissection. Similarly, patients with tumors of the anterior accessory lobe or patients with large anterior tumors may also require the modified Blair incision for adequate surgical exposure. This report serves to revisit the topic of accessory and parotid gland neoplasms to emphasize proper management, particularly the surgical aspects, so that consequences of recurrence are avoided. Methods: This is a retrospective review of our experience with two cases of parotid tumors; one accessory parotid gland neoplasm and one parotid gland neoplasm. We report the case of parotid tumor and epidermal cyst in a 54-year old male patient and the case of case of recurrent parotid tumor with local invasion in 30-year old male patient. Results: All were removed through a modified Blair incision. Pathologic report notified that One was found pleomorphic adenoma and epidermal cyst, and the other one pleomorphic adenoma with subcutenous invasion. The patients recovered well without any complication such as infection, hematoma, facial nerve palsy, and necrosis of skin flap. Patients were discharge POD#7. Patients were followed up to for 1 year and they have no sign of recurrence. Conclusions: A high index of suspicion, prudent diagnostic skills(including fine-needle aspiration biopsy, CT, US), and meticulous surgical approach are the keys to a successful management of these lesions. We experienced two cases of parotid neoplasia, in the treatment of tumor reccurence & iatrogenic tumor arising from the parotid gland and are presented with the review of literatures.