• Archives of Plastic Surgery
• /
• v.36 no.2
• /
• pp.205-210
• /
• 2009

Purpose: Corrugator supercilii muscle pulls eyebrow to inferomedial direction and produces the vertical component of the glabellar line formation. Current techniques for eliminating of glabellar frown include direct resection of corrugators and botulinum toxin injection. Muscle resection in endoscopic face lift procedure is relatively complex and has many disadvantages ranging from possible nerve injury, postoperative edema, pain and a long recovery period. The Botox treatment on the other hand is much more simple in technique but has a short duration of action. The authors have attempted new ways of finding improved treatment of the glabellar frown by selectively blocking of motor nerves innervating the corrugator supercili muscle by using radiofrequency ablation technique. Methods: A total of 80 patients were recruited in our study during the period between Feb. 2007 to June 2008. A probe was introduced from the supraorbital ridge and advanced to the corrugator supercilii muscle. Nerve stimulator was then used to locate the nerve innervating the corrugator and radiofrequency ablation of the nerve was done. Results: In all patients, there were marked improvement in glabellar frown after treatment. There were no reported cases of any relapses during the follow up period. No complication was noted such as facial nerve injury. No patient complained of any adverse symptoms other than slight discomfort due to swelling of the operation site. Conclusion: The treatment of glabellar frown lines using selective nerve block with radiofrequency ablation was not only less invasive but also excellent in surgical outcomes.

• Journal of Acupuncture Research
• /
• v.22 no.6
• /
• pp.51-60
• /
• 2005

Objectives : This study was designed to evaluate the effect of inbalance of autonomic nerve system on peripheral facial palsy patients in comparison of Heart Rate Variability results of healthy control group with that of peripheral facial palsy group. Methods : The peripheral facial palsy patiens who visited the Dongguk university Bundang oriental medicine hospital from April to June in 2005 were tested Heart Rate Variability items which are Mean Heart Rate(MHRT), Standard Deviation of all the Normal RR intervals (SDNN), Root Mean Square of Successive Differences Between The Normal Heart Beats(RMSSD), Total Power(TP), Low Frequency, High Frequency, ratio between the Low Frequency and High Frequency power(LF/HF ratio). The Heart Rate Variability test results of peripheral facial palsy group were compared with the HRV test results of healthy control group who didn't have nervous disease, musculoskeletal disease, heart problem and pain for the past 6 months. Results : 1. MHRT was not significantly different between peripheral facial palsy group and healthy control group(P=0.18). 2. SDNN was not significantly different between peripheral facial palsy group and healthy control group(P=0.41). 3. RMSSD was not significantly different between peripheral facial palsy group and healthy control group(P=0.93). 4. TP was not significantly different between peripheral facial palsy group and healthy control group(P=094). 5. LF and HF were not significantly different between peripheral facial palsy group and healthy control group((P=0.34, 0.30). 6. LF/HF ratio was significantly different between peripheral facial palsy group and healthy control group(P=0.04). Conclusion : LF/HF ratio is generally used as autonomic nerve system evaluation and there was significantly statistical difference between peripheral facial palsy group and healthy control group.

• Journal of Acupuncture Research
• /
• v.33 no.1
• /
• pp.95-101
• /
• 2016

Objectives : The aim of this report was to investigate the effects of Korean medical treatment on facial nerve paralysis with sensorineural hearing loss and tinnitus caused by traumatic temporal bone fracture. Methods : We treated a patient with acupuncture, herbal medicine and physiotherapy. The effect of these treatments was evaluated by House-Brackmann facial grading scale, Yanagihara's unweighted grading system and by Digital Infrared Thermographic Image. Results : After 21 days of Korean medical treatment, House-Brackmann facial grading scale changed from III to II and Yanagihara's unweighted grading score increased from 14 to 27. Digital Infrared Thermographic Image also improved. Conclusions : These results suggest that Korean medical treatments were effective in treating facial nerve paralysis with sensorineural hearing loss and tinnitus caused by traumatic temporal bone fracture. We hope that a more efficient application of this treatment will be the result of clinical data accumulated in future studies.

• Journal of Korean Neurosurgical Society
• /
• v.30 no.6
• /
• pp.755-760
• /
• 2001

Objective : To determine the feasibility of translabyrinthine approach in the vestibular schwannoma patients, the authors reviewed eighteen consecutive cases, focusing at their functional outcome and operative complications. Materials and Method : To evaluate the functional outcome, we reviewed preoperative radiological findings such as size of tumors and location of jugular bulb as well as the preoperative neurological status including audiometric analysis and cranial nerve function in 18 patients, diagnosed as vestibular schwannoma. Also the surgical outcome was evaluated according to the functional preservation of facial nerve and incidence of the surgical complication as well as the extent of surgical resection. Results : The age of patients ranged from 21 to 62 years, with a mean of 50 years. Of 18 patients operated in our center by the translabyrinthine approach, wide exposure with total removal of the mass was possible in 16 cases (88.8%). The facial nerve was anatomically preserved in 88.8%. At six-month follow-up, facial nerve function was good(Grade I-II) in 15 patients(83%) and acceptable(I-IV) in all patients. Although the jugular bulb was highly placed is five patients, gross total resection was possible without facial nerve injury in all patients by the translabyrinthine approach. One patient experienced CSF leakage after surgery, but there was no patient with disabling deficit. Conclusion : Use of the translabyrinthine approach for removal of vestibular schwannomas resulted in good anatomical and functional preservation of the facial nerve, with minimal incidence of morbidity and no mortality. In cases of high jugular bulb impacted into mastoid bone, total removal was possible by displacing the jugular bulb with Surgicel cellulose and placement of bone wax.

• The Korean Journal of Pain
• /
• v.30 no.4
• /
• pp.304-307
• /
• 2017

A 19-year-old male patient presented with facial hemi-atrophy with unilateral spasms of the masseter and temporalis muscles. Ultrasound therapy and Transcutaneous Electric Nerve Stimulation therapy, known as combination therapy, were given on alternate days for 2 weeks. At the end of 2 weeks of combination therapy the patient reported a drastic reduction in the number of episodes of muscle spasm. The visual analog scale score for tenderness of the masseter and temporalis was also markedly reduced. No one has previously used combination therapy for the treatment of facial hemi-atrophy with hemi-facial spasms. The encouraging results of the combination therapy has prompted us to document this study.

• Journal of Korean Neurosurgical Society
• /
• v.42 no.5
• /
• pp.355-362
• /
• 2007

Hemifacial spasm (HFS) is characterized by tonic clonic contractions of the muscles innervated by the ipsilateral facial nerve. Compression of the facial nerve by an ectatic vessel is widely recognized as the most common underlying etiology. HFS needs to be differentiated from other causes of facial spasms, such as facial tic, ocular myokymia, and blepharospasm. To understand the overall craniofacial abnormalities and to perform the optimal surgical procedures for HFS, we are to review the prevalence, pathophysiology, differential diagnosis, details of each treatment modality, usefulness of brainstem auditory evoked potentials monitoring, debates on the facial EMG, clinical course, and complications from the literature published from 1995 to the present time.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.27 no.3
• /
• pp.288-297
• /
• 2005

Rehabilitation of the paralyzed face as a result of trauma or surgery remains a daunting task. Complete restoration of emotionally driven symmetric facial motion is still unobtainable, but current techniques have enhanced our ability to improve this emotionally traumatic deficit. Problems of mass movement and synkinesis still plague even the best reconstructions. The reconstructive techniques used still represent a compromise between obtainable symmetry and motion at the expense of donor site deficits, but current techniques continue to refine and limit this morbidity. In chronically paralyzed face, direct nerve anastomosis, nerve graft, or microvascular-muscle graft is not always possible. In this case, regional muscle transposition is tried to reanimate the eyelid and lower face. Regional muscle includes maseeter muscle, temporalis muscle and anterior belly of the digastric muscle. Temporalis muscle is preferred because it is long, flat, pliable and wide-motion of excursion. In order to reanimate the upper and lower eyelid, Upper eyelid Gold weight implantion and lower eyelid shortening and tightening is mainly used recently, because this method is very simple, easy and reliable.

• Journal of Korean Neurosurgical Society
• /
• v.43 no.1
• /
• pp.57-60
• /
• 2008

The authors herein propose the staged excision as a novel strategy to preserve facial nerve and minimize complication during microsurgery of large vestibular schwannoma (VS). At the first stage, for reducing mass effect on the brain stem and cerebellum, subtotal tumor resection was performed via a retrosigmoid craniotomy without intervention of meatal portion of tumor. With total resection of the remaining tumor, the facial nerve was decompressed and delineated during the second stage translabyrinthine approach at a later date. A 38-year-old female who underwent the staging operation for resection of her huge VS is illustrated.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.41 no.3
• /
• pp.149-155
• /
• 2015

Surgical approaches to the condylar fracture include intraoral, preauricular, submandibular, and retromandibular approaches. Each approach has its own advantages and disadvantages. When a patient needs esthetic results and an intraoral approach is not feasible, the transmasseteric antero-parotid facelift approach is considered. This approach permits direct exposure and allow the surgeon to fixate the fractured unit tangentially. Tangential fixation is critical to osteosynthesis. Disadvantages of the transmasseteric antero-parotid facelift approach include damage to the facial nerve and a longer operation time. However, after the initial learning curve, facial nerve damage can be avoided and operation time may decrease. We report three cases of subcondylar fractures that were treated with a transmasseteric antero-parotid facelift approach. Among these, two cases had trivial complications that were easily overcome. Instead of dissecting through the parotid gland parenchyma, the transmasseteric antero-parotid facelift approach uses transmasseteric dissection and reduces facial nerve damage more than the retromandibular transparotid approach. The esthetic result is superior to that of other approaches.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.14 no.2
• /
• pp.125-133
• /
• 2001

Herpes Zoster Oticus is a reactivation of latent varicella-zoster infection associated otalgia, facial nerve palsy, sensorineural hearing loss and vertigo. Facial nerve palsy is rapid in onset, usually severe degree, and poor is prognosis. And pain in the form of acute neuritis and postherpetic neuralgia is by far the most frequent and most debilitating complication of Herpes Zoster. The pain of Herpes Zoster may severe, but it is usually transitory. Some patients, with the elderly at particular risk, go on to develop postherpetic neuralgia. In the two cases, pain (especially postherpetic neuralgia) which is often severe and, unfortunately, refractory to most forms of treatment was reduced using herbal medicine and acupuncture but facial nerve palsy was not improved.