• Journal of Korean Neurosurgical Society
• /
• v.29 no.6
• /
• pp.744-747
• /
• 2000

Objectives : The purpose of this study was to evaluate the clinical features of the epidermoid tumor of posterior fossa and to assess the surgical outcome. Methods : We reviewed the clinicoradiological records of 10 epidermoid tumor of posterior fossa, treated surgically at our hospital between 1991 and 1996. Results : The mean age of onset was 36 years old and mean duration of symptom was 5.2 years. Six were men and four were women. The location of tumors were cerebellopontine angle(CPA) 5 cases, cerebellum(Cbll)& 4th ventricle 3 cases, foramen magnum 1 case, and pineal region extended to Cbll and 4th ventricle 1 case. Common clinical features were trigeminal neuralgia in 3 cases, cerebellar signs 2 case, headache 2 cases, hemifacial spasm with deafness 1 case, cbll signs and multiple cranial nerve dysfunctions 1 case. One CPA epidermoid had no clinical symptom and sign associated with the tumor. The surgical approaches were suboccipital approach in 9 cases and one transcallosal approach to the tumor of pineal region. The extent of surgical removal was gross total resection in 5 cases and near total or subtotal resection in 5. Two patients with CPA tumor were complicated with facial paresis. One patient with tumor located in cerebellum extended into cisterna magna had postoperative vocal cord paresis. All complicated cases had severe adhesion of tumor capsule with brainstem or cranial nerve. The mean duration of follow up was 26 months. The overall outcome was improvement of symptoms and signs in 6 cases and stationary 4 cases. During follow up, imaging study was done in 7 patients and none of them had finding of tumor recurrence. Conclusion : We conclude that recurrence of tumor is rare in both total and subtotal resected cases, but long-term follow-up is required. Aggressive removal of tumor capsule that adhesed to brianstem or cranial nerve is avoided for preventing severe postoperative complication.

• Journal of Oral Medicine and Pain
• /
• v.35 no.1
• /
• pp.93-99
• /
• 2010

Herpes zoster (HZ) is the secondary manifestation of an earlier infection with the varicella-zoster virus in one or more dermatomes. As reactivation of the virus is linked to an age-related diminished virus-specific and cell-mediated immunity, HZ develops mainly in elderly people. Acute zoster is painful, but does not incur lasting morbidity. Reactivation of the varicella-zoster virus in the trigeminal nerve (Herpes zoster) occur with severe pain and rash in the oro-facial region. The acute pain decreases as the rash begins to heal. Postherpetic neuralgia(PHN), the most frequent complication of herpes zoster, is usually defined as pain in the involved dermatome that is still present 3 month after rash onset. The clinical characteristics of PHN are, eposodic stabbing pain, burning pain and allodynia, with hypoesthesia and/or dysesthesia. $Neurometer^{(R)}$(neuroselective sensory nerve conduction threshold: sNCT, Automated current perception threshold: CPT, neurotron incorporated. Baltimore, Maryland. 21209 U.S.A.) is convenient, rapid and noninvasive, and allows objective assessment of sensory disturbance. This case is about the postherptic neuralgia patient assessed with $Neurometer^{(R)}$. From this case, we reviewed the pathophysiology and the treatment of PHN and recommend the assessment of pain intensity with $Neurometer^{(R)}$ as quantitative and objective method.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.33 no.6
• /
• pp.497-504
• /
• 2011

Purpose: Patients who had a subcondylar fracture with a displaced or deviated condylar segment were treated with a retromandibular approach (RMA) or an endoscope-assisted transoral approach (EATA) in our department of oral and maxillofacial surgery. The clinical results of the approaches were compared. A comparative study of specific approaches for subcondylar fractures has not been published before in Korea. Methods: Twenty-one patients with subcondylar fractures of the mandible were included. Ten patients were treated with the retromandibular approach and 11 were treated with an endoscope-assisted transoral approach. We examined patient age, gender, fracture sites, classifications, period of maxillomandibular fixation, facial nerve (FN) or greater auricular nerve (GAN) injuries, maximal mouth opening, deflection, occlusal changes, number of plates, follow-up period, and other complications. Preoperative computed tomography and pre-operative, post-operative, and follow-up panoramic views were taken of each patient. Results: Mean maximal mouth openings were similar between the two approaches. FN and GAN injuries were more frequent in the RMA group but the deflective rate with mouth opening was higher in the EATA than that in RMA group. Two cases of post-operative infection occurred in the EATA group, and occlusal changes were observed in one case for both approaches. Conclusion: The RMA offers more direct access and visualization of the surgical field but it can cause scars and retractive injuries of the FN and GAN. But, EATA did not result in consequent nerve injuries or scars postoperatively, but unfavorable fractures such as $medial$ $override$ condyles were more difficult to reduce endoscopically. Except cases of an expected difficult reduction, the treatment of choice for a displaced subcondylar fracture may be an EATA.

• Clinical and Experimental Pediatrics
• /
• v.61 no.10
• /
• pp.332-337
• /
• 2018

Purpose: Bell's palsy is characterized by sudden onset of unilateral facial weakness. The use of corticosteroids for childhood Bell's palsy is controversial. This study aimed to identify clinical characteristics, etiology, and laboratory findings in childhood Bell's palsy, and to evaluate the efficacy of corticosteroid treatment. Methods: We conducted a retrospective analysis of children under 19 years of age treated for Bell's palsy between January 2009 and June 2017, and followed up for over 1 month. Clinical characteristics, neuroimaging data, laboratory findings, treatments, and outcomes were reviewed. Patients with Bell's palsy were divided into groups with (group 1) and without (group 2) corticosteroid treatment. Differences in onset age, sex, laterality, infection and vaccination history, degree of facial nerve palsy, and prognosis after treatment between the groups were analyzed. Results: One hundred patients were included. Mean age at presentation was $7.4{\pm}5.62years$. A total of 73 patients (73%) received corticosteroids with or without intravenous antiviral agents, and 27 (27%) received only supportive treatment. There was no significant difference in the severity, laboratory findings, or neuroimaging findings between the groups. Significant improvement was observed in 68 (93.2%) and 26 patients (96.3%) in groups 1 and 2, respectively; this rate was not significantly different between the groups (P=0.48). Conclusion: Childhood Bell's palsy showed good prognosis with or without corticosteroid treatment; there was no difference in prognosis between treated and untreated groups. Steroid therapy in childhood Bell's palsy may not significantly improve outcomes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.27 no.1
• /
• pp.78-82
• /
• 2001

Background : The coronal incision is versatile surgical approach to upper and middle region of the facial skeletal including the zygomatic arch. The advantages of coronal approach are minimal injury of facial tissue including facial nerve and satisfactory cosmetic result by hidden scar at hair. But wide exposure of scalp, its disadvantages are operation time and massive blood loss. Methods : Thirty patients undergoing elective surgery were divided 3 groups. Group I used only coronal approach, group II used coronal with subciliary approach and group III used coronal with subciliary and intraoral approach. And then retrospected of the preoperative, postoperative red blood cell count, hemoglobin(Hb), hematocrit, transfused red blood cell units and platelet cell units, and the amount of infused crystalloids and colloids, and postoperative hemovac count was estimated. Results: 1. Red blood cell count were decreased in all groups at immediated postoperation and decreased in all group of postoperative first day and decreased in group I, II but increased group III of postoperative third day. 2. Hemoglobin and hematocrit were decreased in all group at immediated postoperation and decreased in all group of postoperative first day and decreased in group I, II., but increased group III postoperative third day. 3. Platelet was decreased in all group at immediated postoperation, and decreased in group II, III but increased in group I of postoperative first day and decreased in group I but increased group II, III of postoperative third day. 4. Mean postoperative hemovac mean drainage group I of first day is $48.63{\pm}21.12ml$ and second day is $23.92{\pm}19.53ml$ and third day is $7.82{\pm}5.32ml$ and group II of first day $60.45{\pm}22.65ml$ and second day is $22.14{\pm}13.21ml$ and third day is $7.32{\pm}6.25ml$. III group of first day $58.16{\pm}10.13ml$ and second day is $21.27{\pm}11.72ml$ and third day is $7.13{\pm}4.90ml$. 5. Infusion of group I is mean PRC $1.08{\pm}0.91$ pint, FFP $1.03{\pm}0.75$ pint, crystalloid $2562.23{\pm}1345.53ml$ and group II is mean PRC $1.05{\pm}0.89$ pint, FFP $1.71{\pm}0.78$, crystalloid $2650.47{\pm}1096.36ml$ and group III is mean PRC $1.79{\pm}1.45$ pint, crystalloid $3295.43{\pm}1472.432ml$.

• Journal of Korean Neurosurgical Society
• /
• v.44 no.3
• /
• pp.131-135
• /
• 2008

Objective : Hemifacial spasm (HFS) is considered as a reversible pathophysiological condition mainly induced by continuous vascular compression of the facial nerve root exit zone (REZ) at the cerebellopontine angle. As an offending vessel, vertebrobasilar artery tends to compress much more heavily than others. The authors analyzed HFS caused by vertebrobasilar artery and described the relationships between microsurgical findings and clinical courses. Methods : Out of 1,798 cases treated with microvascular decompression (MVD) from Jan. 1980 to Dec. 2004. the causative vessels were either vertebral artery or basilar artery in 87 patients. Seventy-nine patients were enrolled in this study. Preoperatively, computed tomography (CT) or brain magnetic resonance (MR) imaging with 3-dimentional short range MR technique was performed and CT was checked immediately or 2-3 days after anesthetic recovery. The authors retrospectively analyzed the clinical features. the compression patterns of the vessels at the time of surgery and treatment outcomes. Results : There were 47 were male and 32 female patients. HFS developed on the left side in 52 cases and on the right side in 27. The mean age of onset was 52.3 years (range 19-60) and the mean duration of symptoms was 10.7 years. Many patients (39 cases; 49.1%) had past history of hypertension. HFS caused only by the vertebral artery was 8 cases although most of the other cases were caused by vertebral artery (VA) in combination with its branching arteries. Most frequently, the VA and the posterior inferior cerebellar artery (PICA) were the simultaneous causative blood vessels comprising 32 cases (40.5%). and in 27 cases (34.2 %) the VA and the anterior inferior cerebellar artery (AICA) were the offenders. Facial symptoms disappeared in 61 cases (77.2%) immediately after the operation and 68 cases (86.1%) showed good outcome after 6 months. Surgical outcome just after the operation was poor in whom the perforators arose from the offending vessels concurrently (p<0.05). Conclusion : In case where the vertebral artery is a cause of HFS, commonly branching arteries associated with main arterial compression on facial REZ requires more definite treatment for proper decompression because of its relatively poor results compared to the condition caused by other vascular compressive origins.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.2
• /
• pp.123-128
• /
• 2016

The study was conducted to confirm the analgesic effects of the Carbenoxolone(CBX)and P2X receptor antagonist(iso-PPADS), which separates the gap junction in the facial neuropathic pain model. The experiment used white male Sprague-Dawley rats (240~280g). The second left molars on the lower jaw was extracted to induce facial neuropathic pain, and small dental implants were implanted to induce damage to the inferior alveolar nerve. When CBX was injected twice daily to the abdominal cavity, a significant analgesic effect at 5ug/kg was observed(p<0.05). In addition, when iso-PPADS was injected twice daily into the abdominal cavity, a significant analgesic reaction was observed at $25{\mu}g/kg$(p<0.05). When the two drugs were injected together at a low concentration, in which they did not display an effect, they displayed a significant analgesic reaction at CBX 1ug/kg and iso-PPADS 2.5ug/kg(p<0.05). When a gap injunction block using a low concentration of CBX and a low concentration P2X receptor antagonist was injected together, the pain suppressing effect was observed against the orofacial neuropathic pain mechanism. These results make it possible to determine that the gap junction block using CBX and the injection of the P2X receptor antagonist plays an important role in the pain management of the facial region.

• Journal of Korean society of Dental Hygiene
• /
• v.10 no.4
• /
• pp.655-661
• /
• 2010

Objectives : This study is aimed to prevent the damage to the inferior alveolar nerve during the orthognathic surgery. Methods : The control group consist of 50 patients with class I occlusion. The experimental group consist of 50 patients with class III malocclusion. The cepalometric radiography was used to evaluate the position of the mental foramina. Results : In the first, mental foramen position of class III was more inferior 0.85 mm in the distance between base of mandible and mental foramen. But the distance between occlusal plan and mental foramen had not statistically significant. Secondly, mental foramen location of Mandibular Prognathism was more anterior 0.91 mm in the distance between coronal plane of mandible included pogonion point and mental foramen. Also, the distance of occlusal-coronal plane of mandible included central incisor and mental foramen had statistically significant. The mental foramen location of class III was more anterior 4.81 mm than class I patients. Conclusions : The result of this study could help the clinicians to apprehend fundamental data with various facial skeletal types for any related researches about the location of the mental foramina for other purposes.

• Journal of Haehwa Medicine
• /
• v.15 no.1
• /
• pp.87-95
• /
• 2006

Objective : We suggested the clinical effect of Rainbow therapy on Bell's palsy. Methods : 20 Bell's palsy patients were divided into two groups. One group(A group) was treated by acupunture and the other group(B group) was treated by acupunture and Rainbow therapy. The effect of these treatments was evaluated by Yanagihara's unweighted grading system and House-Brackmann grading system. Results and Conclusions : In Yanagihara's unweighted grading system After 1 week and 2weeks treatment, group B marked more higher than group A in treatment outcome. We discovered that it is significant differences between two groups. After 3 weeks treatment, group B marked more higher than group A in treatment outcome but it is not significant differences between two groups. In House-Brackmann's facial nerve grading system, After 1 week treatment, group B marked more higher than group A in treatment outcome. We discovered that it is significant differences between two groups. After 2 weeks and 3 weeks treatment, group A marked more higher than group A in treatment outcome but it is not significant differences between two groups.

• Journal of Acupuncture Research
• /
• v.19 no.4
• /
• pp.1-15
• /
• 2002

Objective : To observe the biological responses and therapeutic effects of moxibustion and review the trend of related study. Methods : We searched and investigated the journals supplied by Pubmed online site and Je-Han Oriental Medical Academy homepage with the key word "moxibustion". Results : 1. The biological responses of moxibustion reveal on skelectal, digestive, urinary systems, especially blood, angiological systems. 2. The therapeutic effect of moxibustion are analgesic action, controls of excitation or inhibitation of nerve system, improvement of blood circulation, nutrition in organs, increase of absorption of pathlogical product, controls of secreting glands, care of tuberculosis, increase of natural healing power etc. 3. Moxibustions effects on diarrhea, edema, diabetus mellitus, hyperlipiemia, tinnitus, osteoporosis, facial palsy, myopia, pimple etc. 4. Most of moxibustion studys related on immunofunctional actions and renal functional actions. 5. To elevated quality of studies, we needs well-designed epeerimental methods, efficient secure of experimental groups, appropriate statistical verification, accumulations of knowledges about data research. Conclusions : We find out moxibustion is remakble on clinincal therapeutic effects, from now on much more studies are needed to develop this therapy.