• Journal of Korean Neurosurgical Society
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• 제30권6호
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• pp.755-760
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• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권6호
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• pp.376-380
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• 2013

Frey syndrome is a disease characterized by abnormal sweating, facial redness, and rare pain by stimulation of taste sense on the limited area dominated by the auriculotemporal nerve and great auricular nerve. Although the developmental mechanism and histopathologic cause of Frey syndrome are still being debated, the most reliable theory is based on injury of the parathympathetic nerve connected to the auriculotemporal nerve continuing to abnormal regeneration. The other theory is that the sweat glands develop an increased sensitivity after degeneration of sympathetic fibers. Therapy of Frey syndrome includes drugs, radiographic treatment, and surgical treatment; however, in most cases, treatment is not satisfactory. This is a case report on a 24-year-old male patient with Frey syndrome caused by the fracture reduction with retromandibular approach after multiple facial traumas and spontaneous healing without any special treatment.

• Archives of Plastic Surgery
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• 제36권1호
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• pp.80-83
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• 2009

Purpose: Isolated hypoglossal nerve palsy is a rare manifestation of various underlying disease. This article presents a rare complication of general anesthesia associated with an surgical procedure on a case of zygomatic fracture. Methods: An 18-year-old female patient was referred to our department by painful swelling on her left zygomatic area after the traffic accident. Left zygomatic complex fracture was identified on the simple x-ray and facial bone CT scan, and the fracture was treated with open reduction and internal fixation under general anesthesia. On the first postoperative day, she complained of difficulty in swallowing solid food, dysarthria and deviated tongue to her right side. There was no abnormal findings on the neurological examination, brain MRI and routine chemistry. She was diagnosed with transient hypoglossal nerve palsy and dexamethasone with multi-vitamins was administrated intravenously for 5 days. Results: The symptoms were completely resolved by the ninth postoperative day and the patient was discharged without any other complications. Conclusion: The hypoglossal(cranial nerve XII)nerve supplies motor innervation to all of the ipsilateral extrinsic and intrinsic tongue muscles. The hypoglossal nerve damage may caused by the compression between the airway and the hyoid bone during the endotracheal intubation, and direct trauma due to excessive pressure or neck extension. We described a rare case of unintended injury to hypoglossal nerve and care must be taken not to cause the hypoglossal nerve damage especially in facial plastic surgery with excessive neck extension under general anesthesia.

• Archives of Plastic Surgery
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• 제36권6호
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• pp.803-805
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• 2009

Purpose: Many conditions can mimic the presentation of burns. Herpes zoster is one of them. The characteristic features of herpes zoster such as vesicles, pustular lesions and crusts can also be found in burns. Herpes zoster ophthalmicus is a disease caused by recurrent infection of varicella - zoster virus in the ophthalmic division of the trigeminal nerve. This virus frequently affects nasociliary branch and serious ocular complications can occur. Thus, early diagnosis and proper treatment of this disease is important to prevent further ocular manifestations. We report a man who sustained minor facial burn injury that was complicated with herpes zoster ophthalmicus. Methods: A 66 - year - old man visited emergency room with multiple whitish vesicles with serous discharge on right forehead, right medial canthal area and nose. At first he was thought to have a secondary infection of facial burn injury. The vesicles on his face began to form crusts on the next day. Since his skin lesion was located on the ophthalmic division of trigeminal nerve, we also suspected herpes zoster ophthalmicus. He was referred to dermatologist and ophthalmologist. Results: We used antiviral agent (Acyclovir) and NSAIDs for treatment. The patient had no ocular complications. His skin lesion was almost healed after 1 month and remained scars. We treated a patient with minor facial burn complicated with herpes zoster ophthalmicus with antiviral agent. Conclusion: In this work, we describe a case of old patient with herpetic infection and emphasize the need for careful examination to diagnose accurately.

• 대한두개안면성형외과학회지
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• 제10권2호
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• pp.131-134
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• 2009

저자들은 보편적으로 보존치료가 불가능 하여 관혈적 정복술이 필요한 하악의 관절돌기골절 증례에서 당뇨, 고혈압의 병력, 고령으로 인한 절개 및 박리, 전신마취 시간증가로 발생할 수 있는 합병증을 줄이기 위해 우선적으로 시행한 형광투시하의 비관혈적 도수정복만으로 정확한 정복에 성공할 수 있었고 이후 골 유합까지 유지하여 만족스런 결과를 얻었기에 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권4호
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• pp.407-413
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• 1997

The soft tissue injuries of Oral & Maxillofacial region include abrasion, contusion, simple laceration, laceration of skin with underlying tissue, soft tissue injuries combined with facial bone fracture and involving functional structures such as facial nerve and vessel, orbit, lacrimal duct and salivary gland and so on. The results obtained were as follows ; 1. The age range was 1 to 97, and the highest incidence occured in the 3rd decade(23.4%), followed by the 1st decade(20.2%), 4th decade(18.1%), 4th decade(18.1), and 5th decade(14.3%) 2. The sexual ration was 4 : 1(M : F). 3. The most common cause of facial laceration was a accident(54.5), followed by blow(17.8%), traffic accident(15.9%) and unknown(10.8%). 4. The most frequently occurred site of injury was a forehead(24), followed by oral cavity(16.9%), lip(15%), eyebrow(14.5%), cheek(14%), chin(11.8%), nose(2%), scalp(1.4%) and neck(0.9%). 5. Most of wound size was less than 3cm in length. 6. 28 patients suffered facial bone fracture, representing 7%. 7. The major complications following facial laceration were infection and facial paralysis caused by facial nerve injuries, representing 4.5% and 1.9%.

• Annals of Clinical Neurophysiology
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• 제6권1호
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• pp.26-30
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• 2004

Background: Electrophysiologic study accurately predicts the degree of degenerated motor axons but cannot give precise information on the type of injury that occurred in Bell's palsy. Because of these limitation for prognostic prediction in Bell's palsy, we evaluated divergence of electrophysiological time course for the purpose of presuming the type of injury in Bell's palsy. Methods: We did bilateral facial nerve conduction studies in 103 Bell's palsy patients, who visited to Han-Gang sacred heart hospital from 1998 to 2001. We compared the CMAP amplitude of disease site with that of normal site and suggested that decremental CMAP amplitude ratio (percentage) as a degree of denervation of affected facial nerve. Then we demonstrated the time course of denervation percentage. After defining normal range of CMAP amplitude difference from normal control group, we also evaluated if distinct time course of early minimal denervation is present. Results: Our results show that time course of the denervation in early stage of Bell's palsy reflect various injury type such as axonotmesis, neurotmesis or other unidentified type. We cannot identify the distinct time course of early minimal denervation. Conclusions: The time course as well as the maximal value of denervation are the best prognostic guidelines in Bell' s palsy. So repeated serial electrophysiologic test are inevitable to assess prognosis. As an another topic, early minimal denervation for prognostic prediction deserve to be evaluated as a future work up for prognostic prediction.

• 대한두개안면성형외과학회지
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• 제19권2호
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• pp.157-161
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• 2018

A sialocele is a subcutaneous cavity containing saliva, most often caused by facial trauma or iatrogenic complications. In subcondylar fractures, most surgeons are conscious of facial nerve injury; however, they usually pay little attention to the parotid duct injury. We report the case of a 41-year-old man with a sialocele, approximately $5{\times}3cm$ in size, which developed 1 week after subcondylar fracture reduction. The sialocele became progressively enlarged despite conservative management. Computed tomography showed a thin-walled cyst between the body and tail of the parotid gland. Fluid leakage outside the cyst was noted where the skin was thin. Sialography showed a cutting edge of the inferior interlobular major duct before forming the common major duct that seemed to be injured during the subcondylar fracture reduction process. We decided on prompt surgical treatment, and the sialocele was completely excised. A duct from the parotid tail, secreting salivary secretion into the cyst, was ligated. Botulinum toxin was administrated to block the salivary secretion and preventing recurrence. Treatment was successful. In addition, we found that parotid major ducts are enveloped by the deep lobe and extensive dissection during the subcondylar fracture reduction may cause parotid major duct injury.

• 대한약침학회지
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• 제16권3호
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• pp.7-10
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• 2013

Objectives: This study aimed to evaluate the evidence available in the literature for the safety and efficacy of Dioscoreae Rhizoma (DR) for the treatment of peripheral neuropathy. Methods: Literature searches were performed in MEDLINE and three Korean medical databases up to April 2013. All studies evaluating the effects on peripheral neuropathy or the safety of DR monopreparations were considered. Results: Three studies - DR extract per os (po) on diabetic neuropathy in mice, DR extract injection on the peripheral sciatic nerve after crush injury in rats and DR extract injection to patients with peripheral facial paralysis proved that DR treatments were effective for the treatment of nerve injuries. Conclusions: In conclusion, we found the DR has a strong positive potential for the treatment of peripheral neuropathy, but studies addressing direct factors related to the nerve still remain insufficient.

• Journal of Korean Neurosurgical Society
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• 제46권3호
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• pp.277-280
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• 2009

Posterior cranial fossa subdural hematomas and extension of the subdural hematoma to the cerebellopontine angle is rarely seen and the concurrent development of acute peripheral facial palsy and the management strategy have not previously been reported in this pathology because of its rarity. We present this case to emphasize that minor head trauma may lead to a posterior cranial fossa hematoma extending to the cerebellopontine angle and cause peripheral facial palsy in patients using aspirin (acetylsalicylic acid). In addition, partial evacuation and waiting for the resorption of the hematoma may help to prevent damage to the 7th and 8th cranial nerves.