• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권2호
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• pp.55-61
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• 1990

Patients with facial paralysis, in whom nerve damage is irreparable or in whom the innervation of the paralyzed musculature cannot be restored by nerve suture, grafting, or cross-face nerve transplantation, should be offered some form of reconstructive static and dynamic aid. Temporalis muscle-fascia unit used as a circumorbital sling and motor unit is a dynamic controlled reconstructive procedure, but it has several disadvantages such as wide surgical exposure, bulky-looking at lateral canthal area, insufficient voluntary control. This is a case report of facial palsy of posttraumatic lagophthalmos of 41-year-old male, which was corrected by temporalis muscle-tendon transfer with plantaris tendon transplantation.

• 대한두개안면성형외과학회지
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• 제18권1호
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• pp.65-70
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• 2017

A 25-years-old woman with mandibular prognathism underwent a mandibular setback by way of mandibular sagittal split ramus osteotomy (MSSRO). After 2 days of operation, she developed difficulty of closing her right eye. The blink reflex test and motor nerve conduction study of the right orbicularis oris muscle were revealed right facial neuropathy of unknown origin and House-Brackmann facial nerve grading system (HBFNGS) grade V. For treatment, we initially prescribed oral prednisolone and nimodipine including physical therapy. The samples consisted of 11 facial nerve palsy patients caused by MSSRO and were analysed about onset of facial nerve palsy, postoperative HBFNGS, final HBFNGS, treatment method and recovery time. At 10 weeks of treatment of nimodipine, she had completely regained normal function (HBFNGS grade I) of the right facial nerve. The clinical results lead to assume a fast recovery of facial nerve function by the nimodipine medication, whereas average time of recovery is 16.32 weeks in references. Despite of the limited one patient treated, the result was very promising with respect to a faster recovery of the facial nerve function. Considering the use of nimodipine treatment for peripheral facial nerve palsy following a surgical approach with an anatomically preserved nerve can be recommended.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권2호
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• pp.143-149
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• 2020

Objectives: Long-term facial paralysis results in degeneration of the distal nerve segment and atrophy of the supplied muscles. Options for these patients include free muscle transfer, temporalis myoplasty, and botulinum toxin injections for smile reanimation. In this study we aimed to evaluate the subjective and objective outcomes of these procedures. Materials and Methods: In our study, we retrospectively analyzed smile symmetry in patients with facial palsy (n=8) who underwent facial reanimation procedures. Results: Subjective analysis showed high satisfaction in seven out of eight patients. Objective analysis showed statistically significant improvement postoperatively in both vertical and horizontal smile symmetry at rest and during maximum smile (P<0.001). Conclusion: Choosing the ideal procedure for the patients is the most critical aspect for facial reanimation. Though free muscle transfer is considered gold standard procedure, temporalis myoplasty also gives satisfactory results. Residual synkinesis which can lead to disturbing aesthetic deformity can be effectively treated with botulinum toxin.

• 한방안이비인후피부과학회지
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• 제4권1호
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• pp.89-98
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• 1991

Clinical study on the 114 facial paralysis patients, visited Won Kwang University Oriental Medical Hospital in Kwang ju from July 1990 to Jun 1991, was carried out. The results obtained are as follows. 1. Prevalence was almost same in both sexes and high in the age of 3 and 4 decades but distributed in an age group. 2. Majority of the patients were nomotensive, which meant blood pressure did not affect the incidence. 3. The incidence distributed in every occupations but high in housewife as 37 cases ($32\%$) and decreased gradually in office employee, labor worker, student and merchant in order. 4. Overwork, wind and cold, emotional stress, and numerous implicated agents were etiological factor. 5. The paralysis mostly occured in summer and winter as 40($35\%$) and 37 cases($32\%$) respectively, 18($16\%$) and 19cases($17\%$) were recorded respectively in spring and autumn. 6. The majority of patients showed only facial muscle paralysis without other complications, whose cure rate was $60\%$ (47 cases). The patients with auditory impairment or taste loss was less common and cure rate was low. 7. The number of the patients with migraine or mastoid pain was 81($71\%$), which was more than 33 patients($29\%$) with such pain. The cure rate was high in the patients without migraine than with migraine as a raito of 64 to $46\%$. 8. Most of duration from attack to admission were in a week as 86 cases($75\%$) and the patients with duration over 4 weeks 11 cases($10\%$). The cure rate of the patients in a week, was 54 cases($60\%$) and the patients over 4 weeks was none($0\%$), which meant shorter the duration was, the beter the result was. 9. Response on electro acupuncture on initiating therapy showed good in 39 cases($34\%$) the majority group, moderate in 37 cases, exellent in 29 cases and poor in 5 cases. 10. The results of treatment were as follows : asymptomatic in 58 cases($51\%$), improved n 40cases($35\%$), effective in 10 cases($9\%$) and ineffective in 6 cases($5\%$). 11. Cure rate according to the response on electro acupuncture showed $72\%$ in exellent group, $59\%$ in good group, $27\%$ in moderate groop, and $0\%$ in poor group. These show the better the response on the electro-acupuncture is, the higher the cure rate is, which will be able to indicate the prognosis of facial paralysis.

• 대한한방내과학회지
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• 제39권5호
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• pp.1075-1083
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• 2018

Objective: Facial nerve palsy is caused by damage to the seventh cranial nerve. It is the main symptom of facial muscle paralysis on the affected side. If the patient cannot receive proper treatment, severe permanent impairments, both physical and mental, may result, so this disease must be treated appropriately. In this study, a patient with facial nerve palsy was admitted to a Korean medicine hospital for treatment. This case study reports on the patient's progress and the effects of the treatment. Methods: We treated the patient with herbal medicines, acupuncture, herbal acupuncture therapy, and physical therapy. The House-Brackmann Grading System and a weighted regional grading system were used to assess symptom changes. Results: The patient with facial nerve palsy was hospitalized for 50 days and recovered from symptoms without significant problems in the face or to motor function. Conclusion: This case report demonstrates the possibility of treating facial nerve palsy using Korean medicine.

• 대한후두음성언어의학회지
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• 제23권2호
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• pp.111-118
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• 2012

Botulinum toxin is a potent neurotoxin that is produced by the bacterium Clostridium botulinum. The agent causes muscle paralysis by preventing the release of acetylcholine at the neuromuscular junction of striated muscle. Botulinum toxin A (Botox, AllerganInc., Irvine, California) is the most potent of seven distinct toxin subtypes that are produced by the bacterium. The toxin was initially used clinically in the treatment of strabismus caused by hypertonicity of the extraocular muscles and was sub-sequently described in the treatment of multiple disorders of muscular spasticity and dystonia. In treating patients with Botox for blepharospasm, Carruthers and Carruthers [5] noticed an improvement in glabellar rhytids. This ultimately led to the introduction and development of Botox as a mainstay in the treatment of hyperfunctional facial lines in the upper face. Since its approval by the U.S. Food and Drug Administration for the treatment of facial rhytids (2002), botulinum toxin A has expanded into wide-spread clinical use. Forehead, glabellar, and periocular rhytids are the most frequently treated facial regions. Indications for alternative uses for Botox in facial plastic and reconstructive surgery are expanding. These include a variety of well-established procedures that use Botox as an adjunctive agent to enhance results. In addition, Botox injection is finding increased usefulness as an independent modality for facial rejuvenation and rehabilitation. The agent is used beyond its role in facial rhytids as an effective agent in the management of dynamic disorders of the face and neck. Botox injection allows the physician to precisely manipulate the balance between complex and conflicting muscular interactions, thus resetting their equilibrium state and exerting a clinical effect. This article will address some of the new and unique indications on Botox injection in the face (the lower face and neck, combination with fillers). Important points in terms of its clinical relevance will be stressed, such as an understanding of functional facial anatomy, the importance of precise injections, and correct dosing all are critical to obtaining natural outcomes.

• 한방안이비인후피부과학회지
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• 제32권3호
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• pp.254-261
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• 2019

Objective : Miller-Fisher syndrome(MFS) is a type of acute inflammatory polyneuropathy, a disease characterized by abnormal muscle coordination, absence of tendon reflexes, and paralysis of the eye muscle. This study is to report a case of delayed facial palsy and dizziness in Miller-Fisher syndrome, treated with traditional Korean medicine. Methods : A 57-year-old male was diagnosed with Miller-Fisher syndrome accompanied by neurological symptoms such as right facial palsy and dizziness. He received traditional Korean medicine treatment such as acupuncture(including pharmacopuncture, needle embedding therapy, electroacupuncture) and herbal medicine for 17 days. Results : Each neurological symptoms were improved after traditional Korean medicine. In case of facial palsy, House Brackmann Grading System was reduced form grade 3 to grade 2, and Sunnybrook Scale was improved from 39 to 55. Also, other symptoms such as dizziness and headache was also improved. Conclusions : This case report suggests that traditional Korean medicine may have a role in treating neurological symptoms such as facial palsy and dizziness in patient diagnosed with Miller-Fisher syndrome.

• Journal of Acupuncture Research
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• 제17권3호
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• pp.87-98
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• 2000

This study is designed to evaluate the clinical implications of Gd-DPTA (Gadolinium-diethyl enetriamine pentacetic acid) enhanced MRI(Magnetic resonance imaging) in Bell's palsy and find it's usefulness in Oriental Medicine In this study, 25 outparients with Bell's palsy were studied that MRI was performed. To evaluate degree of facial palsy, H-B(House-Brackmann) Grade was used. In Oriental Medical therapy, Acupuncture and Herbal medicine were treated. Subjective cause was divided into exposure to chill, fatigue, stress, mixed cases. Enhanced site was compared with symptoms which were disorder of eye, hearing, taste, and facial muscle palsy. Also, Relation between time which was performed MRI and enhancement was analyzed. The enhanced lesion in MRI was divided into five segments; Internal audiitory canal, Labyrinthine segment, Geniculate ganglion, Tympanic segment, Mastoid segment. In Bell's palsy, 20 of 25 patients(80%) had abnormal contrast enhancement of the facial nerve. The H-B grade and interval performed MRI from onset were directly proportionate to enhancement. That is to say, Severe facial palsy short interval show high possibility of enhancement. There was no relation between subjective causes and enhanced site of facial nerve in MRI. Also Clinical symptoms didn't coincide with MRI findings.

• 대한장애인치과학회지
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• 제2권1호
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• pp.39-44
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• 2006

Cerebral palsy(CP) is one of the most common motor disease, due to brain injury during fetal and neonatal development which results in neuromotor paralysis and associated neuromuscular symptoms. Features of CP include motor disability due to the lack of muscle control, often accompanied by sensory disorders, mental retardation, speech disorders, hearing loss, epilepsy, behavior disorders, etc. There are increasing chances of treatment of dental patients with cerebral palsy, as the occurrence of CP is increasing with the decrease in infant mortality and an increase in immature birth and premature birth and also, there is a trend to pursue of higher quality of life. Reports on the relationship between CP and maxillofacial deformity are uncommon, but it is well known that the unbalance and discontrol of the facial muscles, lip, tongue and the jaws leads to malocclusion and temporomandibular joint disorders, and statistics show that class 2 relationship of the jaws and open bite is frequently reported. However, it is difficult to perform maxillofacial deformity treatment, which consists of orthodontic treatment, maxillofacial surgery and muscle adaptation training, due to difficulties in communication and problems of muscle adaptation caused by difficulties in motor control which leads to a high recurrence rate. This case report is to trearment of maxillofacial deformity in CP patient. A 26 year old female patient came to the department with the chief complaint of prognathism of the mandible and facial asymmetry. According to the past medical history, she was diagnosed as cerebral palsy 1 week after birth, classified as GMFC, classII accompanied with left side torticollis. The patient's intelligence was moderate, and there were no serious problems in communication. For two years time, the patient underwent lingual frenectomy, pre-operation orthodontic treatment and then bimaxillary orthognathic surgery to treat mandibular prognathism and facial asymmetry followed by rehabilitatory exercise of facial muscle. After 6 months of follow up, there was a good result. This is to report to the typical signs and symptoms of DFD in CP patient and the limitation of the usual method of the treatment of DFD in CP patient with literature review.

• Clinical and Experimental Pediatrics
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• 제52권12호
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• pp.1388-1391
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• 2009

Poland 증후군은 일측 대흉근의 부재나 저형성과 다양한 동측 손기형을 특징으로 한다. Mobius 증후군은 완전 혹은 불완전의 안면마비를 특징으로 하는 선천적 신경학적 이상을 말한다. 이들의 병인은 명확히 밝혀지지 않았지만, 이환된 측의 혈류가 감소됨으로서 발생된다 여겨지고 있다. 2.670 g 남자아이가 38주 3일에 왼쪽 안면마비와 우심증이 동반된 왼쪽 흉벽 결손에 2번째, 3번째 손가락 합지증을 가지고 태어났다. Poland-Mobius 증후군은 드물며, 세계적으로 우심증과 관련된 증례는 단지 2례 밖에 없었다. 이에 우리는 우심증이 동반된 Poland-Mobius 증후군의 국내 첫 증례를 보고하는 바이다.