• Archives of Plastic Surgery
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• v.34 no.1
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• pp.44-51
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• 2007

Purpose: Blow-out fracture is one of the most common fractures in facial trauma. It is diagnosed by Computed Tomography(CT) scan, which is considered as the most effective diagnostic tool. Since, the Picture Archiving Communication System(PACS) has been provided recently to many hospitals, doctors are more familiar with imaging software of PACS. Because this software has many useful measuring tools, doctors can measure orbital structure easily and make a plan for treatment with its data. Therefore, authors intended to analyze the data of orbital structure measured with PACS imaging software and evaluate its usefulness. Methods: The charts and CT images of 100 patients, which were 50 patients with medial wall fracture and 50 patients with floor fracture, were reviewed. Patients were selected by pre-determined criteria and their CT images were measured with image software of PACS. 'Extraocular muscle thickness', 'Defect ratio'(ratio of defect area to normal area) and 'Globe position index' were measured and analyzed statistically. Results: The thickness of inferior rectus muscle and medial rectus muscle was simultaneously increased in acute-stage of blow-out fracture. The medial rectus muscle was more thickened in medial wall fracture and inferior rectus was more thickened in floor fracture, respectively. In acute blow-out fracture, globe position is exophthalmic rather than enophthalmic. Especially in floor fracture, numerical value summed up thickness of all extraocular muscle is correlated to the defect ratio and globe position index. Conclusion: Clinicians can decide globe position or presume defect ratio in inferior wall fracture by measurement of CT image in acute blow-out fracture using PACS.

• Journal of Oriental Neuropsychiatry
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• v.12 no.1
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• pp.201-207
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• 2001

Oculomotor nerve is the third cranial nerve, controlls four of the six extraocular muscles(superior rectus muscle, medial rectus muscle, inferior rectus muscle and inferior oblique muscle), levator palpebrae superioris muscle, cilliary muscle and muscle sphincter pupillae. In the oculomotor nerve palsy, limited oculogyration, diplopia, blepharoptosis, accomodation paralysis and mydriasis can be occured. We experienced an improved case of the oculomotor nerve palsy patient treated with oriental medicine for 25days. We used herbal medicine and acupuncture. Based on this experience, it is considered that oriental medicine can be applied to the treatment of the oculomotor nerve palsy.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.729-734
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• 2007

Purpose: The operative treatment for blow-out fracture involves restoration of intra-orbital soft tissue and bony structural integrity. There are several methods for reconstruction of inferior blow out fracture. We report reduction of inferior blow-out fracture with urinary balloon catheter in comparison with $Medpor^{(R)}$ using group to complication rate. Methods: A retrospective study was performed on 67 patients who underwent inferior orbital blow-out fracture reconstruction with $Medpor^{(R)}$ implant or urinary balloon catheter following between 2003 and 2006. Hospital records were reviewed especially for preoperative and postoperative enophthalmos, diplopia, extraocular muscle movement limitations, and hypoesthesia between $Medpor^{(R)}$ implant group and balloon catheter using group. Results: There was no significant statistical difference between both groups on incidence of postoperative complications of enophthalmos, diplopia, extraocular muscle movement limitations, and hypoesthesia. Postoperative infection, ectropion were absent in both groups.Conclusion: The use of urinary balloon catheter is simple, fast and inexpensive. Urinary balloon catheter is an alternative and reliable use for reduction of inferior orbital blow-out fracture.

• Journal of Korean Ophthalmic Optics Society
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• v.15 no.1
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• pp.117-122
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• 2010

Purpose: The purpose of this study was to measure the active force of extraocular muscles on mono- and binocular movements for 62 healthy koreans (male: 29, female: 33). Methods: The force of adduction, abduction, elevation and depression, of right and left eye on monocular movement were tested with horizontal moving distance based on corneal limbus and the force of superior oblique muscle and inferior oblique muscle on binocular movement were measured with vertical moving distance between corneal limbus. The distances were obtained by high resolution digital image processing. Results: At monocular movements of tested subjects. the power of abduction, adduction, elevation and depression of right and left eye were (male) 9.35 nun, 9.75 mm, (female) 9.02 mm, 9.52 mm, (male) 10.23 mm, 10.16 mm, (female) 10.17 mm, 10.07 mm, (male) 7.01 mm,6.91 mm, (female) 6.98 mm, 6.64 mm, (male) 7.52 mm, 6.82 mm, (female) 7.52 mm, 6.67 mm, respectively. The active force of binocular movements were 54.8% hyperergasia and 45.1% hypergasia/67.7% hyperergasia and 32.2% hypergasia with inferior oblique muscle, 64.5% hyperergasia and 35.5% hypergasia/58.1% hyperergasia and 41.9% hypergasia with superior oblique muscle, respectively. Conclusions: The force of horizontal movement was higher than vertical movement. The value of adduction was higher than abduction on horizontal movement, and the value of depression was higher than elevation on vertical movement. In the both of inferior and superior oblique muscle, the ratio of hyperergasia was higher than that of hypergasia.

• Journal of Oriental Neuropsychiatry
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• v.22 no.4
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• pp.135-142
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• 2011

Objectives : The purpose of this case was to investigate the effectiveness of electroacupuncture for ophthamoplegic migraine. Methods : We provided electroacupuncture therapy and prescribed oriental medicine, Joganiknoe-tang daily. We measured patient's pain by VAS(Visual Analogue Scale) and eye movement with a ruler every five days. Results & Conclusions : Any patient who has a headache with paresis of the extraocular muscle should be considered for ophthalmoplegic migraine. To diagnose ophthalmoplegic migraine, family history, past medical history, associated symptoms and signs, neurologic examinations and neuroimaging tests are needed. The symptoms of patient improved gradually within 26days from the first day of admission, and we can see her complete recovery.

• The Korean Journal of Physiology
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• v.6 no.2
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• pp.49-56
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• 1972

This experiment was designed to explore specific functional relationship between the vestibular canals and the extraocular oblique muscles by observing the isometric tension responeses of the muscles to the selected vestibular canal excitation. The vestibular excitation was simulated by either stimulation of the individual canal nerve or endolymphatic fluid displacement in each canal. Each canal nerve was subjected to square wave pulses with a monopolar wire electrode placed closely to the ampullary nerve endings for electrical stimulation, and a fine stainless cannula was introduced into the each canal toward the ampulla and a minute amount $(0.5{\sim}3.5\;microliter)$ of fluid was injected in or ejected out by means of a microsyringe connected to the cannula to produce ampullopetal or ampullofugal displacement of endolymphatic fluid. The superior oblique muscle was contracted by the excitation of homolateral canals and was relaxed by contralateral canals. On the contrary, the inferior oblique was contracted by the contralateral canals and was relaxed by the homolateral canals. Summation of excitatory and inhibitory canal effects from the bilateral vestibular system was demonstrable on the tension changes of the oblique muscles. Excitation of either dual or triple canals of the unilateral vestibular system also caused summation effect on the tension response of the oblique pair; thus multiple signals from the different ampullary receptors seems to be converged into the relevant ocular motor muclei. Since the superior and inferior obliques are known to receive their motor fibers from the contralateral trochlear nuclei and intermediate nuclei of the homolateral oculomotor complex respectively, the above experimental evidences indicate that the ocular motor nuclei for oblique muscles receive excitatory signals from the contralateral vestibular canals and inhibitory signals from the homolateral canals.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.553-559
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• 2008

Purpose: The lateral orbital wall fractures have been previously classified by some authors. As there are some limitations in applying in their own classifications, we hope to present a refined classification system of the lateral orbital wall fracture and to identify the correlation between the specific type of the fracture and clinical diagnosis. Methods: The facial bone CT scans and medical records of 78 patients with the lateral orbital wall fractures were reviewed in a retrospective manner. The classification is based on the CT scan. In type I, the fracture and its segments are away from the lateral rectus muscle and in type II, they are next to or slightly pushing the muscle in axial CT scan. In type III, the fracture segments compress and displace the longitudinal axis of the muscle or the optic nerve in axial view of CT scan. Type IV fracture includes multiple fractures found around the orbital apex or optic canal in coronal view of CT scans of the type I and type II fractures. Results: The most common fracture pattern was type I(43.6%), followed by type IV(29.5%), type II(20.5%), and type III(6.4%). As diplopia and restriction of extraocular muscles were found in type I and II fractures, severe ophthalmic complications such as superior orbital fissure syndrome, orbital apex syndrome, and traumatic optic neuropathy were found in type III and IV fractures almost exclusively. Conclusion: We propose an easy classification system of the lateral orbital wall fracture which correlates closely with ophthalmic complications and may help to make further treatment plan. In Type III and IV fractures, severe ophthalmic complications may ensue in higher rates, so early diagnosis and treatment should be performed.

• Journal of Korean Neurosurgical Society
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• v.46 no.2
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• pp.156-160
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• 2009

Solitary extramedullary plasmacytomas are isolated plasma cell tumors of soft tissue that typically do not metastasize. They are rare and account for 4% of all plasma cell tumors. To our knowledge, only 14 cases of solitary extramedullary plasmacytomas in the sphenoid sinus have been reported. A 32-year-old man presented to our department with complaint of ocular pain in the right eyeball and diplopia. Physical and neurological examinations revealed intact and prompt direct and indirect light reflexes in both pupils and limitation of extraocular muscle movement seen with the lateral gaze of the right eyeball. Magnetic resonance imaging suggested the presence of mucocele or mycetoma, therefore surgical resection was performed with endoscopic endonasal transsphenoidal approach. Histopathology was consistent with plasmacytoma. Systemic work-up did not show any evidence of metastasis and the sphenoid sinus was the sole tumor site, and therefore the diagnosis of solitary extramedullary plasmacytoma was confirmed. We report a rare case of solitary extramedullary plasmacytoma in the sphenoid sinus with successful treatment using the endoscopic endonasal transsphenoidal resection and adjuvant radiotherapy.

• The Journal of Pediatrics of Korean Medicine
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• v.30 no.2
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• pp.23-30
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• 2016

Objectives The purpose of this study is to investigate recent clinical studies on effect of acupuncture for strabismus in Korea and other countries. We have analyzed 10 years (from 2006 to 2015) of case studies and randomized controlled trials (RCT) on effect of acupuncture for strabismus. Methods The search database includes Oasis, KTKP (Korean Traditional Knowledge Portal), Medline, Embase, and Cochrane library. To narrow the search, the following key search terms were used: 'strabismus, acupuncture'. The search was limited to the publication date from 2006 to 2015. 7 case studies and 5 control studies were selected for analysis. Results and Conclusions 1. The acupuncture treatment is effective for paralytic strabismus 2. The studies used BL1, GB1, ST2, TE23, GB15, EX-HN5, ST1, and LI4 acupoints and also an electroacupuncture treatment, which is 15 minutes of extraocular muscle stimulation, was used. 3. Degree of strasbismus was tested by Ocular motor range test, Corneal light reflex test, Ocular abducent scale test (Scott and Kraft, Diploptic range test).

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.524-527
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• 2007

Purpose: Globe displacement due to a blowout fracture is a rare clinical phenomenon. The authors present reduction of a globe displacement to the maxillary sinus due to trauma suffered in a fall and the reconstruction of a large defect left in the medial and inferior orbit. Methods: A 39-year-old male patient was unable to open his left eye after being struck on the periorbital area by a metal edge. Laceration was not noted in that area but we were unable to observe the intraorbital globe. A facial computed tomography (CT) scan showed that the globe was displaced through the maxillary sinus. A transconjunctival approach was used to access the infraorbital margin and the globe entrapped in the inferior margin of the orbit was successfully reduced. A large defect in the medial and inferior orbit was reconstructed using a graft from the iliac bone. Results: In 5 months after the operation, no atrophy of the globe was seen. Both sides retained a similar shape. A satisfactory functionality outcome in terms of improved extraocular muscle movement, and a satisfactory aesthetical outcome were achieved. Conclusion: The authors report the reduction of a globe displaced to the maxillary sinus following a fall and the reconstruction of the large defect left in the medial and inferior orbit.