• The Korean Journal of Pain
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• v.12 no.1
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• pp.128-131
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• 1999

Stellate ganglion block is a well established method for the management of certain pain syndromes (e.g., chronic regional pain syndrome, facial pain) in the cervicothoracic region and upper extremity. The stellate ganglion resides between the C7 transverse process and the head of the first rib. Anesthetic injections for the stellate ganglion block are typically made at the level of the transverse process of either the C6 or C7 vertebrae to avoid the pleura, vessels, and nerve roots. Method of positioning the needle tip directly at the ganglion has been described, but are problematic because of the risk of injury to or injection into adjacent structures. It is necessary to know the exact anatomic position of the stellate ganglion when permanent blockade is required by means of radiofrequency thermocoagulation. Whereas fluroscopy shows only bony feature, computerized tomography also images nerves, vessels, and lung, allowing accruate needle placement. We report a case of the percutaneous radiofrequency thermocoagulation of the stellate ganglion after computerized tomography-guided localization.

• Journal of Oral Medicine and Pain
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• v.43 no.3
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• pp.70-76
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• 2018

The definition and application of disability are becoming more important as society becomes more complex. The precise criteria for the assessment and classification of disabilities are primarily focused on certain medical conditions with a lack of guidelines for dental conditions. This study provides an evaluation and comparison of the current tables available for the assessment of disabilities in the dental field with the aim of identifying areas to be improved.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.3
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• pp.159-163
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• 2016

Orofacial pain is a common complaint of patients that causes distress and compromises the quality of life. It has many etiologies including trauma, interventional procedures, nerve injury, varicella-zoster (shingles), tumor, and vascular and idiopathic factors. It has been demonstrated that the sympathetic nervous system is usually involved in various orofacial pain disorders such as postherpetic neuralgia, complex regional pain syndromes, and atypical facial pain. The stellate sympathetic ganglion innervates the head, neck, and upper extremity. In this review article, the effect of stellate ganglion block and its mechanism of action in orofacial pain disorders are discussed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.25.1-25.4
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• 2016

Background: Bilateral sagittal split ramus osteotomy (BSSRO) is the most widely used mandibular surgical technique in orthognathic surgery and is easy to relocate the distal segments, accelerating bone repair by the large surface of bone contact. However, it can cause neurosensory dysfunction (NSD) or sensory loss by injury of the inferior alveolar nerve. The purpose of the present study was to evaluate NSD after BSSRO and modifiers at NSD recovery. Methods: In this study, NSD characteristics after BSSRO from 2009 to 2014 at the Kyung Hee University Dental Hospital were evaluated. The pattern of sensory recovery over time was also evaluated based on factors such as field of sensory dysfunction, surgical procedure, presence of pre-operative facial asymmetry, and postoperative medications. Results: Most of the patients had shown NSD immediately after orthognathic surgery. Among the 1192 sides of 596 patients, NSD was observed in 953 sides and 544 patients. Sexual predilection was shown in males (p value = 0.0062). In the asymmetric group of 132 patients, NSD was observed in 128 patients (96.97 %). In the symmetric group of 464 patients, NSD was observed in 416 patients (89.45 %); on the other hand, NSD was observed significantly higher in the asymmetric group (p = 0.025). NSD-associated factors were analyzed, and vitamin B12 may be beneficial for NSD recovery. Conclusions: There was a difference between the symmetric group and the asymmetric group in NSD recovery. Vitamin B12 can be regarded as an effective method to nerve recovery. However, a further prospective study is needed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.5
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• pp.447-453
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• 2010

The hemifacial microsomia is characterized by variable underdevelopment of the craniofacial skeleton, external ear, and facial soft tissues. So, patients with hemifacial microsomia have an occlusal plane canting and malocclusion with facial asymmetry. Distraction osteogenesis (DO) with an intraoral or extraoral device is a technique using tension to generate new bone with gradual bone movement and remodeling. DO has especially been used to correct craniofacial deformities such as a hemifacial microsomia, facial asymmetry, and mandible defect that could not adequately be treated by conventional reconstruction with osteotomies. It has a significant advantage to lengthen soft and hard tissue of underdeveloped site without bone graft and a few complication such as nerve injury or muscle contracture. A 13-years old girl visited our clinic for the chief complaint of facial asymmetry. She had a left hypoplastic maxilla and mandible, occlusal plane canting and malocclusion. We diagnosed hemifacial microsomia and lanned DO to lengthen the affected side. Le Fort I osteotomy, left mandibular ramus and symphysis osteotomy were performed. The internal distraction devices fixed with screw on maxillary and mandibular ramus osteotomy sites. External devices were adapted to lower jaw for DO on symphysis osteotomy site and to upper jaw for rapid maxillary expansion (RME). At 7days after surgery, distraction was started at the rate of 1mm per day for 13days, and after 4months consolidation periods, distraction devices were removed. Simultaneous multiple maxillo-mandibular distraction osteogenesis with RME resulted in a satisfactory success in correcting facial asymmetry as well as occlusal plane canting for our hemifacial microsomia.

• Journal of Korean Physical Therapy Science
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• v.5 no.3
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• pp.643-650
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• 1998

Facial nerve is subject to injury at any point in the course from the cerebral cortex to the motor end plate in the face, so many etiologic varieties of facial paralysis may be encountered, including trauma, viral infection and the idiopathic. Authors have studied 39 cases of facial paralysis which had experienced of treatment in our department from March, 1996 to March, 1997 at Dong San Medical Center. The results obtained are as follows : 1) The highest age incidence showed 10 cases(24.6%) in 3rd decade 2) Among the total of 39 cases, male were 21 cases(53.8%) and female were 18cases(46.2%). 3) At the involved side, left side were 19 cases(48.7%) and right side were 18 cases(46.2%). 4) The causes of facial paralysis were; idiopathic (Bell's palsy) in 19 cases(48.7%) infectious in 6 cases(15.4%) neoplastic in 6 cases(15.4%) traumatic in 5 cases(12.9%) metabolic in 2 cases(5.1%) congenital in 1 cases(2.6%) 5) In time interval between onset of symptom and treated initial date, 26 cases(66.7%) in below 10 days and 8 cases(20.5%) in 11-20 days 6) Correlation of recovery rate according to the treated duration did not differ significantly 7)Result after treatment were satisfactory

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.1
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• pp.12-20
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• 1994

Generally, the totally paralyzed face can never be made normal by any of the current methods of reconstruction. Careful selection of patients based on sound judgment of what can and cannot be achieved by the proposed surgical technique is paramount to a successful operation and a satisfied patient. The results are related to time of delayed between injury and repair ; the shorter the delay the better are the results. The objectives in correcting facial paralysis are to achieve normal appearance at rest ; symmetry with voluntary motion ; control of the ocular, oral, and nasal sphincter ; symmetry with involuntary emotion and controlled balance when expressing when expressing emotion ; and no significant functional deficit secondary to the reconstructive surgery. It must be employed a number of concepts, for treatment of the paralyzed face by surgeon, depending on the cause, time interval, and wound characteristics, as well as the availability of and necessity for neuromuscular substitution. Nerve grafts, crossovers, muscle transfers, free muscle and nerve-muscle grafts, micronuerovascular muscle transfers, and regional muscle transposition are the principal methods being developed. We applied the temporal musle transposition for reanimation of unilatrally paralyzed faces for long times on two patients. The results of muscle transposition can be enhanced by the patient's learning to activate the transposed muscle by voluntary effort, and are best in patients who are motivated to learn the necessary motor-sensory coordination techniques.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.2
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• pp.183-187
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• 2005

The coronal approach has been used for over a century by neurosurgeons to access to the anterior cranium. Indications for the coronal approach expanded from use in the correction of congenital skeletal anomalies to applications in acute maxillofacial trauma and secondary deformity correction, oncologic surgery and reconstruction, and esthetic surgery. Complications were such as injury to frontal branch of the facial nerve, motor nerve paralysis, hematoma under flap, trismus, ptosis, epiphora, infection and anterior temporal depression. $Medpor^{(R)}$ is made up of dense polyethylene connected in porous structures. It is easily shapable without collapsing the pores due to it's hardness and tissue growth takes place at the porosities. Based on these advantages, $Medpor^{(R)}$ has been used in augmentation and restoration in craniofacial defect. A temporal depression after the coronal approach for treatment of Le Fort III fracture was successfully reconstruction with $Medpor^{(R)}$ and we report this case with review of literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.2
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• pp.215-219
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• 1999

This article discusses the diagnosis, anatomic consideration, and surgical management of masseter muscle hypertrophy. Surgical correction is advised for patients who have esthetic complaints. Esthetic improvement can be achieved by surgery and not by conservative treatment. Recently, the intraoral method, which leaves no scar on the face and minimizes the possibility of injury to the marginal branch of the facial nerve, has been supported by many surgeons. Patients who complained of marked swelling of unilateral or bilateral mandibular angle area and showed abnormal bony growth at the mandibular angle area and enlarged masseter muscle received mandibular angle shaving and excision of the inner layer of masseter muscle with intraoral approach. After operation, physiotherapy was done with EAST(eletrical acupuncture stimulation therapy) for encouraging the mouth opening and reducing the swelling. They showed early maximum mouth opening and reduction of swelling.

• Imaging Science in Dentistry
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• v.51 no.3
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• pp.313-321
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• 2021

Ankylosis of the temporomandibular joint (TMJ) is a disabling disease resulting from fibrous or bony fusion of the mandibular condyle and the glenoid fossa. Early diagnosis and surgical treatment are essential to prevent facial deformity and other complications. Conventional radiography has limitations in demonstrating the true extent of ankylosis. It is important for surgeons to be aware of the size and degree of bony ankylosis in order to perform complete resection of the ankylotic mass. In addition, a detailed evaluation of the relationship with adjacent vital structures such as the internal maxillary artery, inferior alveolar nerve canal, external auditory canal, and skull base are crucial to avoid iatrogenic injury. Multidetector computed tomography (MDCT) is the current imaging modality of choice for preoperative assessments. Herein, the authors propose a structured CT reporting template for TMJ ankylosis to strengthen the value of the preoperative imaging report and to reduce the rates of intraoperative complications and recurrence.