• Archives of Plastic Surgery
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• v.48 no.3
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• pp.282-286
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• 2021

Recent reports have described several cases of double muscle transfers to restore natural, symmetrical smiles in patients with long-standing facial paralysis. However, these complex procedures sometimes result in cheek bulkiness owing to the double muscle transfer. We present the case of a 67-year-old woman with long-standing facial paralysis, who underwent two-stage facial reanimation using two superficial subslips of the serratus anterior muscle innervated by the masseteric and contralateral facial nerves via a sural nerve graft. Each muscle subslip was transferred to the upper lip and oral commissures, which were oriented in different directions. Furthermore, a horizontal fascia lata graft was added at the lower lip to prevent deformities such as lower lip elongation and deviation. Voluntary contraction was noted at roughly 4 months, and a spontaneous smile without biting was noted 8 months postoperatively. At 18 months after surgery, the patient demonstrated a spontaneous symmetrical smile with adequate excursion of the lower lip, upper lip, and oral commissure, without cheek bulkiness. Dual-innervated muscle transfer using two multivector superficial subslips of the serratus anterior muscle may be a good option for long-standing facial paralysis, as it can achieve a symmetrical smile that can be performed voluntarily and spontaneously.

• Journal of Korean Academy of Nursing
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• v.46 no.4
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• pp.542-551
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• 2016

Purpose: The purpose of this study was to examine the effects of a facial muscle exercise program including facial massage on the facial muscle function, subjective symptoms related to paralysis and depression in patients with facial palsy. Methods: This study was a quasi-experimental research with a non-equivalent control group non-synchronized design. Participants were 70 patients with facial palsy (experimental group 35, control group 35). For the experimental group, the facial muscular exercise program including facial massage was performed 20 minutes a day, 3 times a week for two weeks. Data were analyzed using descriptive statistics, ${\chi}^2$-test, Fisher's exact test and independent sample t-test with the SPSS 18.0 program. Results: Facial muscular function of the experimental group improved significantly compared to the control group. There was no significant difference in symptoms related to paralysis between the experimental group and control group. The level of depression in the experimental group was significantly lower than the control group. Conclusion: Results suggest that a facial muscle exercise program including facial massage is an effective nursing intervention to improve facial muscle function and decrease depression in patients with facial palsy.

• The Journal of Korean Physical Therapy
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• v.26 no.4
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• pp.240-248
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• 2014

Purpose: The purpose of study was to determine the effects of muscle reeducation training in patients with acute facial nerve paralysis. Methods: Thirty patients were randomly assigned to either the experimental group (n=15) or the control group (n=15). The experimental group received muscle reeducation training for 20 minutes after electrotherapy and the control group received conventional electrotherapy for only 40 minutes. Therapeutic intervention for each group was performed four times per week for four weeks. The patients were measured for recovery of paralysis using the House-Brackmann Grading System (H-B grade), the Movement Distance of Mouth, Nasolabial Angle (NA), and Facial Disability Index (FDI). Results: In within group comparison, the experimental group showed significant improvements for all variables (p<0.01). In comparison between two groups, the experimental group showed relatively greater significant improvements for all variables (p<0.01). Conclusion: These findings suggest that muscle reeducation training is more effective than conventional therapy in improving the condition of patients with facial nerve paralysis. In particular, the results of this study indicate that muscle reeducation training can be recommended by clinicians since it provides more benefits.

• Journal of Oral Medicine and Pain
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• v.26 no.2
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• pp.157-160
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• 2001

Facial nerve paralysis(or Bell's palsy) which commonly occurs unilaterally, gives rise to paralysis of facial expression muscle. This condition is classified into symptomatic facial nerve paralysis due to intracranial tumor, post operative trauma, etc. and idiopathic facial nerve paralysis. To explain the etiology of idiopathic facial nerve paralysis, many hypothesis including ischemic theory, viral infection, exposure to cold, immune theory etc. were suggested, but there is no agreement at this point. The method to evaluate the facial nerve paralysis, when it occurs, consists of three stage scale method, image thechnics like CT and MRI, laboratory test to examine the antibody titers of viral infection, neurophysiologic test to evaluate the degree and prognosis of paralysis. Treatment includes medication, stellate ganglion block(SGB), surgery, physical therapy and other home care therapy. In medication, systemic steroids, vitamins, vasodilating-drug and ATP drugs were used. SGB was also used repeatedly to attempt the improvement of circulation and to stimulate the recovery of nerve function. Physical therapy including electric acupuncture stimulation therapy(EAST) and hot pack was used to prevent the muscle atrophy. When No response was showed to this conservative therapies, surgery was considered. After treating two patients complaining of Bell's palsy with medication(systemic steroids) and EAST, favorable result was obtained. so author report the case of facial nerve paralysis.

• Journal of Korean Physical Therapy Science
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• v.16 no.1
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• pp.1-10
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• 2009

Background: The purpose of this study was to determine the effect of massage and muscle reeducation training with conventional treatment in patients with facial paralysis. Methods: Twenty-five patients with facial nerve paralysis were randomly allocated to 3 groups: massage, muscle reeducation training, and control groups. Therapeutic intervention for the massage (n=8) and muscle reeducation training (n=8) groups consisted of conventional therapy such as application of hot pack and electrical stimulation plus massage therapy and muscle reeducation training, respectively. The control group (n=9) received only conventional therapy. Therapeutic intervention for each group was performed 6 times per week for 4 weeks. The patients were assessed by using the House-Brackmann Grading System (H-B grade) and Yanagihara Unweighted Grading System (Y grade) once every week. Results: The H-B and Y grades improved significantly in all 3 groups after a 4-week intervention (p<.01). At 3 and 4 weeks, the H-B and Y grades of the massage group improved significantly when compared with those of the control group (p<.01). Muscle reeducation training group showed significant improvements in the scores of the two grades with time when compared with the massage and control groups (p<.01). The rate of change in the H-B grade was significantly different between the control and muscle reeducation training groups (p<.01), and that of change in the Y grade was significantly different between the control and muscle reeducation training groups (p<.01) and between the control and massage groups (p<.01). Conclusion: These findings suggest that massage and muscle reeducation training are more effective in improving the condition of patients with facial nerve paralysis than conventional therapy. In particular, the results of this study indicate that muscle reeducation training can be recommended by clinicians since it provides more benefits.

• Archives of Plastic Surgery
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• v.32 no.3
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• pp.281-286
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• 2005

The goal in facial paralysis treatment is to achieve the normal appearance of the face as well as to reconstruct the natural symmetrical smile. In cases of facial paralysis, a widely accepted procedure is the two stage method, which combines neurovascular free muscle transfer with cross face nerve grafting. Although the results are promising, the two operations of this method, which are about 1 year apart, impose an economic burden on the patients and require a lengthy period before results are obtained. In order to overcome these drawbacks, one stage method, using latissimus dorsi neurovascuular free muscle flap was introduced. Between January 2000 and January 2004, fifteen patients with long standing facial paralysis were treated in the Korea University Anam Hospital. The segmental latissimus dorsi with long nerve and pedicle was transferred to the paralyzed side of the face. The first postoperative movement of the transferred muscle was reported at 8.9 months, faster than that of the two stage method. During the next 24 months, a constant increase in the power of muscle contraction was observed. The fifteen cases were evaluated within an average of 31.7 months following the surgery and satisfactory results including muscle contraction were obtained in eleven of the cases but muscle contraction was not found in three cases.

• Journal of Acupuncture Research
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• v.29 no.1
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• pp.1-8
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• 2012

Objectives : We investigate the characteristics of foot reflex zone acupoint of facial paralysis patients. Methods : In order to make a comparison between facial nerve paralysis patient group and non-facial paralysis group, we measured foot reflex zone acupoint detection in both group of 18 patients who were diagnosticated to facial nerve paralysis and 18 persons who were not. Results : 1. In comparing the means of the foot reflex zone, the measurements of facial nerve paralysis group is different significantly from non-facial paralysis group(p<0.05). 2. The measurement of detection of foot reflex zone acupoints, such as hypophysis(垂體), nose(鼻), cerebrum(大腦), neck(頸項), Trapezius muscle(僧帽筋), eye(眼) and ear(耳) of the facial nerve paralysis group is different significantly in comparison with non-facial paralysis group(p<0.05). But the measurement of detection of foot reflex zone acupoints, such as trigeminal nerve(三叉神經), cerebellum (小腦), kidney(腎), ureter(輸尿管) and urinary bladder(膀胱) of the facial nerve paralysis group is not defferent significantly in comparison with non-facial paralysis group(p>0.05). Conclusions : The results suggest that foot reflex zone can be used in the diagnosis and treatment of facial nerve paralysis.

• The Journal of Korean Medicine
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• v.37 no.2
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• pp.45-52
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• 2016

Objectives: The purpose of this study is to evaluate the clinical effects of Muscle Energy Technique(MET) for peripheral facial paralysis. Methods: 60 Patients were divided into two groups. Group A(n=30) received the treatment with existing Korean medicine. Group B(n=30) received the MET with existing Korean medicine. It was performed once a day, five time per a week for three weeks. we analyzed Yanagihara's score and House-Brackmann scale Results: A week after MET treatment, Yanagihara's score average of Group A is $7.17{\pm}6.34$. Yanagihara's score average of Group B is $8.84{\pm}5.22$. (p=0.72). Two weeks after MET, Yanagihara's score average of Group A is $12.39{\pm}4.94$. Yanagihara's score average of Group B is $15.12{\pm}3.20$. (p=0.04). Three weeks after MET, Yanagihara's score average of Group A is $17.11{\pm}5.31$. Yanagihara's score average of Group B is $22.78{\pm}3.67$. (p=0.01). A is $3.87{\pm}1.36$. House-Brackmann Scale average of Group B is $3.64{\pm}1.76$. (p=0.63). Two weeks after MET treatment, House-Brackmann Scale average of Group A is $3.20{\pm}0.97$. House-Brackmann Scale average of Group B is $3.02{\pm}1.03$. (p=0.05). Three weeks after MET, House-Brackmann Scale average of Group A is $2.84{\pm}1.12$. House-Brackmann Scale average of Group B is $2.23{\pm}0.78$. (p=0.04). Conclusion: MET treatment is effective for improve the symptoms of peripheral facial paralysis. Therefore, it will be used to peripheral facial paralysis.

• Archives of Craniofacial Surgery
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• v.25 no.1
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• pp.1-10
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• 2024

The facial nerve stimulates the muscles of facial expression and the parasympathetic nerves of the face. Consequently, facial nerve paralysis can lead to facial asymmetry, deformation, and functional impairment. Facial nerve palsy is most commonly idiopathic, as with Bell palsy, but it can also result from a tumor or trauma. In this article, we discuss traumatic facial nerve injury. To identify the cause of the injury, it is important to first determine its location. The location and extent of the damage inform the treatment method, with options including primary repair, nerve graft, cross-face nerve graft, nerve crossover, and muscle transfer. Intracranial proximal facial nerve injuries present a challenge to surgical approaches due to the complexity of the temporal bone. Surgical intervention in these cases requires a collaborative approach between neurosurgery and otolaryngology, and nerve repair or grafting is difficult. This article describes the treatment of peripheral facial nerve injury. Primary repair generally offers the best prognosis. If primary repair is not feasible within 6 months of injury, nerve grafting should be attempted, and if more than 12 months have elapsed, functional muscle transfer should be performed. If the affected nerve cannot be utilized at that time, the contralateral facial nerve, ipsilateral masseter nerve, or hypoglossal nerve can serve as the donor nerve. Other accompanying symptoms, such as lagophthalmos or midface ptosis, must also be considered for the successful treatment of facial nerve injury.

• The Journal of Korean Medicine
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• v.29 no.3
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• pp.131-143
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• 2008

Objectives: Electroacupuncture has the effect of recovering paralytic nerves and muscles. To treat disproportional muscles of expression with electroacupuncture, it is essential that we know the correct point of paralytic muscle. Methods: We investigated 20 cases of patients with facial palsy sequelae. We measured nasolabial angles, checked grade of muscle palsy, and tested ENoG. Results: This study showed significant correlation between nasolabial angles with these muscle groups (zygomatic group I, zygomatic group II, orbicularis oris muscle). Conclusions: Disproportional facesare fixed by muscles of expression observed in facial palsy sequelae. We can treat muscular paralysis of these muscle groups with electroacupuncture for more complete recovery.