• Archives of Craniofacial Surgery
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• v.20 no.6
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• pp.421-424
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• 2019

Osteomas are benign, slow-growing osteogenic lesions frequently found in the craniomaxillofacial region. They can be classified as peripheral, central, or extraskeletal. Reactive mechanisms to trauma or infection, as well as muscle traction, are thought to play a major role in the development of peripheral osteomas. In the present report, a 41-year-old woman presented with a slowgrowing, painless mass on her left eyebrow. She had suffered trauma 15 years prior. In the computed tomography scan, a 2.5×2×0.7-cm radio-opaque tumor was detected just medial to the left supraorbital foramen, and a peripheral osteoma was clinically diagnosed. An elective operation under general anesthesia was planned. Following a suprabrow incision, subcutaneous and intramuscular dissection was performed. In the surgical plane deep to the corrugator muscles and superficial to periosteum, a branch of the supratrochlear nerve was encountered and preserved using a vessel loop. The osteoma beneath the periosteum was extracted in multiple fragments using a chisel and mallet to minimize trauma to the nerve. Contour and facial symmetry were corrected. To use a suprabrow incision, the surgeon must understand neighboring anatomical structures, including the course of the supratrochlear and supraorbital neurovascular bundles. When these structures are located adjacent to tumor lesions, careful surgical maneuvers should be performed to preserve them.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.33 no.4
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• pp.133-144
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• 2020

Objectives : The purpose of this study is to report the effect of Korean medicine treatment on limitation of eye movement in Miller-Fisher Syndrome. Methods : A patient was treated with herbal medicines, acupuncture(including electropuncture, phamacopuncture), Moxibustion and cupping therapy. To evaluate the result of this treatment, we used photographs of eye movement, Scott and Kraft score of both eye, length of eyeball movement and visual analogue scale(VAS) for subjective symptoms. Results : After treatment, the limitation of eye movement and diplopia were remarkably improved. Also, other symptoms such as dizziness, gait disturbance, facial nerve disorder were disappeared. Conclusions : This study suggests that Korean medicine treatments are effective for patient with limitation of eye movement in Miller-Fisher Syndrome.

• Archives of Craniofacial Surgery
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• v.13 no.1
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• pp.22-28
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• 2012

Purpose: In accordance to an increased interest in facial appearance and the popularization of computed tomography scanning, the number of diagnosis and treatment of blowout fractures has been increased. The purpose of this article is to review pure blowout fracture surgery through transconjunctival incision focusing on complications and their management. Methods: In this retrospective study, 583 patients, who had been treated for pure blowout fracture through transconjunctival incision from 2000 to 2009, were evaluated. Their hospital records were reviewed according to their sex, age, fracture site, preoperative presentations, time interval between trauma and surgery, and postoperative complications. Results: According to postoperative follow-up results, there were early complications that included wound dehiscence and infection (0.2%), hematoma (insomuch as extraocular movement is limited) (0.7%), lacriminal duct injury (0.5%), and periorbital nerve injury (0.7%). In addition, there were late complications that lasted more than 6 months, that included persistent diplopia (1.7%), extraocular movement limitation (0.9%), enophthalmos (1.0%), periorbital sensation abnormalities (1.0%), and entropion (0.5%). Conclusion: We propose the following guidelines for prevention of postoperative complications: layer by layer closure; bleeding control with the epinephrine gauzes, Tachocomb, and Tisseel; conjunctival incision 2 to 3 mm away from punctum; avoidance of excessive traction; performing surgical decompression and high dose corticosteroid therapy upon confirmation of nerve injury; atraumatic dissection and insertion of Medpor Barrier implant after securing a clear view of posterior ledge; using Medpor block stacking technique and BioSorb FX screw fixation; performing a complete resection of the anterior ethmoidal nerve during medial wall dissection; and making an incision 2 to 3 mm below the tarsal plate.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.2
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• pp.144-152
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• 1991

Various muscular flaps are used in oral and maxillofacial reconstructive surgery for the defects caused by tumor resection and trauma or for the correction of head and neck deformities. The sternocleidomastoid(SCM) muscle may be widely used as a muscular or myocutaneous flap in these lesion. The authors used SCM muscular flap for the expected parotid defect following benign tumor related conservative parotidectomy in three cases. We expected that prevention of post-operative facial deformity, reduction of dead-space and protection of denuded facial nerve etc. is lead by SCM muscular flap. But the total SCM flap can lead to some complications such as "flat neck deformity", limitation of neck movement and overcontouring of parotid defect. Therefore, the authors used split pedicled SCM muscular flap and it lead good favorable results of post-operative functional and esthetic problems.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.2
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• pp.19-27
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• 1989

Hemifacial microsomia is characterized underdevelopment of the TMJ, mandibular ramus, and associated muscles of mastication. The Maxilla and malar bones on the affected side frequently are underdeveloped. The contiguous parotid gland may be hypoplastic. Preauricular sinus tracts and tags may exist, along with underdevelopment of the associated external ear, and affected facial nerve and muscles of facial expression may also show dysfunction. Children exhibiting the more classic signs will be identified at birth. Little is known about the etiology of hemifacial microsomia. We have corrected surgically a 22-year-old woman with hemifacial microsomia. We have performed leveling Le Fort I osteotomy with iliac bone graft on the maxilla, reverse-L osteotomy and iliac bone graft on the right mandibular ramus, vertical ramus osteotomy on the left side, onlay bone graft on the right mandibular body, and augmentation genioplasty. The postoperative course was uneventful and restoration of facial asymmetry was achieved.

• Journal of Acupuncture Research
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• v.29 no.3
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• pp.139-148
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• 2012

Objectives : The purpose of this case is to report the improvement of two patients diagnosed with eight and a half syndrome after combination therapy of oriental and western medicine. Methods : We treated the patients with combination therapy of oriental and western medicine such as acupuncture, moxibustion, herbal medication, antithrombotic agents and steroid therapy. Changes of peripheral facial paralysis were evaluated using House-Brackmann facial grading system and the degree of dizziness, tenderness and pain of upper abdomen were assessed using numerous rating scale. Changes in motor grade of upper and lower extremities were evaluated using medical research council scale. Results : We have recently experienced two cases of eight and a half syndrome - a syndrome characterized by the coexistence of one and a half syndrome, a rare ophthalmoparetic syndrome characterized by a conjugate horizontal gaze palsy in one direction and an internuclear ophthalmoplegia in the other, and cranial nerve VII palsy. The one and a half syndrome was caused by acute cerebral infarction. Two patients in this report were improved through combination therapy of oriental and western medicine. Conclusions : We report the clinical course and treatment methods of eight and a half syndrome.

• Journal of Korean Neurosurgical Society
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• v.39 no.3
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• pp.183-187
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• 2006

Objective : Hemifacial spasm has characteristic and specific electrophysiological finding, lateral spread response[LSR]. We study the correlation between change of lateral spread response during microvascular decompression[MVD] and clinical outcome after MVD. Methods : Sixty two patients with hemifacial spasm who were treated with microvascular decompression from March 2000 to February 2003 were included in this study. The monitoring of intraoperative facial electromyography[EMG] and brain stem auditory evoked potential were performed. Results : In 28 [44.7%] patients, there was persistence of lateral spread response after vascular decompression in root exit zone of facial nerve. Among these 28 patients, 9 had mild hemifacial spasm at discharge. Three out of 34 patients who had intraoperative disappearance of lateral spread response after MVD had mild hemifacial spasm. But Both groups, disappearance of LSR [Group I], and persistence [Group II] had only 2 patients with mild hemifacial spasm, and 5 patients at 3 months, respectively. Conclusion : Although intraoperative EMG monitoring is very useful in assessing the efficacy of MVD, the clinical outcome of MVD in patient with hemifacial spasm does not always correlate with EMG finding. The prognostic value of intraoperative LSR monitoring in the long-term results is questionable.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.17.2-19
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• 1982

The sinus tympani is subject to great variability in the size, shape and posterior extent. A heavy compact bony zone, especially in the posterior portion and the narrow space between the facial nerve and posterior semicircular canal are the limitation of surgical approach. The facial recess should be opened, creating a wide connection between the mesotympanum and mastoid in the Intact canal wall tympanoplasty with mastoidectomy. The surgically created limits of the facial recess are the facial nerve medially, the chorda tympani laterally and the bone adjacent to the incus superiorly. Using adult Korean's thirty-five temporal bones, the authors measured the osteologic reslationship in the posterior tympanum, especially sinus tympani and facial recess. The result was as followed. 1. The average distance from the anterior end of the pyramidal eminence. 1) to the edge of the sinus tympani directly posterior was 2.54(1.05-5.40)mm. 2) to the maximum posterior extent was 3.22(1.25-7.45)mm. 3) to the maximum cephaled extent was 0.67 (0.40-1.75)mm. 2. The boundary of the sinus tympani was 82.9% from the lower margin oval window to the upper margin round window niche. 3. The deepest part of the sinus tympani was 62.9% in the mid portion, between the ponticulus and subiculum. 4. The oblique dimension from the fossa incudis above to the hypotympanum below was 8.13(7.90-9.55)mm. 5. The transverse dimensions midway between the oval window above and round window below was 3.00(2.85-3.45)mm. 6. The transverse dimension at the level of the fossa incudis was 1.81(1.40-2.15)mm. 7. The facial nerve dehiscence was 14.3%. 8. Anterior-posterior diameter of the footplate was 2.98(2.85-3.05) mm. 9. The average distance from the footplate. 1) to the cochleariform process was 1.42(1.35-1.55) mm. 2) to the round window niche was 1.85(1.45-2.10) mm.

• Annals of Clinical Neurophysiology
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• v.10 no.2
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• pp.104-108
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• 2008

Background: The compression of 7th cranial nerve by arteries is one of the various causes of hemifacial spasm (HFS). A few previous studies were revealed the relation between the compression of 7th cranial nerve and common trunk anomaly. We evaluated the common trunk anomalies in patients with HFS using MRI and MRA. Methods: From January 2001 to December 2005, 41 consecutive patients (9 men, mean age $54.5{\pm}12.6$) with HFS underwent MRI and MRA. T2 axial images and time-of-flight angiographies were reviewed for identification of the compression at root exit zone by two neuroradiologists and one neurologist. Results: Thirty-seven patients showed neurovascular compression on the lesion side. Twenty patients of them were shown the compression of 7th cranial nerve by anterior inferior cerebellar artery (AICA), and seventeen patients of them were shown the compression by posterior inferior cerebellar artery (PICA). Twenty-four patients of the thirty-seven patients had common trunk anomaly. In control, twelve of twenty-one subjects had common trunk anomaly, that the frequencies of common trunk anomaly of two groups were 58.8% in HFS and 57.1% in controls. In the twenty-four patients with common trunk anomaly, eighteen patients had dominant-AICA, and six patients had dominant-PICA. The rate of nerve compression by common trunk anomaly in the HFS with unilateral common trunk, dominant-AICA was 76.5% and dominant-PICA was 100%. Conclusions: This study also revealed that AICA was most common compressive artery. There was no difference between the HFS groups and control groups in frequency of common trunk anomaly. Thus, we could not demonstrate the relationship between common trunk anomaly and HFS.

• Journal of Oral Medicine and Pain
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• v.33 no.4
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• pp.295-303
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• 2008

The lingual branch of the trigeminal nerve transmitts general sensation from anterior two thirds of the tongue, also bearing within sheath fibers of chordal tympani branch of the facial nerve. Chorda tympani nerve carries special taste sensations from the anterior two thirds of the tongue and sub-serves the existing trigeminal pathway. Chorda tympani nerve and the lingual nerve innervate to fungiform papilla and distribution of fungiform papilla on tongue dorsum is variable according to anatomical location. The purpose of this report is to assess that the relationship of the number of fungiform papilla and the ability of two-point discrimination of tongu dorsum. Twenty-six healthy students(male:female=13:13) whose mean age was $30{\pm}3$ participated in our study. Two-point discrimination thresholds were measured to evaluate the spatial acuity of touch sensation. The measurement was carried out at the tip and posterolateral region of dorsal tongue. After two-point discrimination test, we took the pictures of their dorsal tongue dyed with methylene blue with digital camera. There were no significant differences between the number of fungiform papilla and the two-point discrimination threshold. But, we found that there were the intraregional and intersubject variations of spatial acuity of the tongue. During the test on the posterolateral region of the dorsal tongue, students appealed the difficulty of discrimination of one point and two point.