• Journal of Dental Anesthesia and Pain Medicine
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• 제24권2호
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• pp.129-135
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• 2024

Concomitant chemoradiotherapy (CCRT) treated patients experience various complications. We present a rare case of post-CCRT Bell's palsy and describe its various possible causes, so as to increase awareness among clinicians about Bell's palsy being a CCRT-associated adverse effect. The patient was a 48-year-old man diagnosed with squamous cell carcinoma who presented with post-CCRT Bell's palsy. After radiotherapy for 6 weeks (overall 67.5 Gy) and four rounds of cisplatin chemotherapy, he complained of paralysis of the entire left face. A test was performed 33 days after the last CCRT session to differentiate Bell's palsy from other causative factors. Based on magnetic resonance imaging findings, facial nerve invasion due to tumor size increase was determined to not cause Bell's palsy. Inflammation of the left Eustachian tube was observed. Hence, steroids and famciclovir were administered, which markedly improved the facial paralysis symptoms within 56 days after facial paralysis development. In conclusion, patients can develop Bell's palsy owing to complex effects of various CCRT mechanisms. Although the exact cause of Bell's palsy has not been identified and the effectiveness of drug treatment was questionable in this case, unlikely causative factors should be excluded through various tests and appropriate and timely measures must be adopted.

• Journal of Acupuncture Research
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• 제19권5호
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• pp.112-123
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• 2002

Background and Objective : The evaluation of facial nerve function is a complex procedure. The House-Brackmann facial nerve grading system(H-B grade)and the Yanagihara grading system(Y-system) have been recommended as universal standards for assessing the degree of facial nerve palsy. The purpose of this study is to compare the effectiveness of Y-system and H-B system and to know the advantages of each system for each stage of incomplete recovery or sequelae of facial paralysis. Materials and Methods : A comparison between H-B grade and Y-system was studied with 137 evaluations of 61 cases of incomplete recovery or sequelae of peripheral facial paralysis. Each case was graded by using H-B system as a gross system and Y-system as a regional system before treatment, after 12 weeks and 6 months Results and Conclusions : The range of score in the Y-system 0-6, 8-16, 14-22, 24-34, 32-38, 38-40 were matched with grade VI, V, IV, III, II and I in the H-B system. The percentage of H-B grade III was the greatest among 137 evaluations and y-system showed the greatest score range. H-B system is easy to use but Y-system is more objective, quantitative and convenient to use in the incomplete recovery or sequelae state.

• 대한한방내과학회지
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• 제40권5호
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• pp.760-767
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• 2019

Objective: This study reports the efficacy of using integrative Korean medicine treatments for a patient with facial paralysis and accompanying trigeminal neuralgia. Methods: A 45-year-old male patient with left side facial palsy and facial pain due to Bell's palsy with trigeminal neuralgia was treated with herbal medicine, acupuncture, pharmacopuncture, and cupping for 18 days. The treatment effect was evaluated by measuring the scores for the numerical rating scale (NRS) of facial pain, the House-Brackmann scale, and the Yanagihara scale. Results: After the hospital treatment, the patient's facial pain NRS score was decreased, and the House-Brackmann scale and Yanagihara scale scores improved after the administration of the Korean medicine treatments. Conclusions: The integrative Korean medicine treatments appeared to be effective in treating facial nerve palsy and associated trigeminal neuralgia.

• 대한두개안면성형외과학회지
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• 제25권2호
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• pp.99-103
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• 2024

Because facial nerve injuries affect the quality of life, leaving them untreated can have devastating effects. The number of patients with traumatic and iatrogenic facial nerve paralysis is considerably high. Early detection and prompt treatment during the acute injury phase are crucial, and immediate surgical treatment should be considered when complete facial nerve injury is suspected. Symptom underestimation by patients and clinical misdiagnosis may delay surgical intervention, which may negatively affect outcomes and in some cases, impair the recovery of the injured facial nerve. Here, we report two cases of facial nerve injury that were treated with nerve grafts during the subacute phase. In both cases, subacute facial nerve grafting achieved significant improvements. These cases highlight surgical intervention in the subacute phase using nerve grafts as an appropriate treatment for facial nerve injuries.

• 한방안이비인후피부과학회지
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• 제4권1호
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• pp.89-98
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• 1991

Clinical study on the 114 facial paralysis patients, visited Won Kwang University Oriental Medical Hospital in Kwang ju from July 1990 to Jun 1991, was carried out. The results obtained are as follows. 1. Prevalence was almost same in both sexes and high in the age of 3 and 4 decades but distributed in an age group. 2. Majority of the patients were nomotensive, which meant blood pressure did not affect the incidence. 3. The incidence distributed in every occupations but high in housewife as 37 cases ($32\%$) and decreased gradually in office employee, labor worker, student and merchant in order. 4. Overwork, wind and cold, emotional stress, and numerous implicated agents were etiological factor. 5. The paralysis mostly occured in summer and winter as 40($35\%$) and 37 cases($32\%$) respectively, 18($16\%$) and 19cases($17\%$) were recorded respectively in spring and autumn. 6. The majority of patients showed only facial muscle paralysis without other complications, whose cure rate was $60\%$ (47 cases). The patients with auditory impairment or taste loss was less common and cure rate was low. 7. The number of the patients with migraine or mastoid pain was 81($71\%$), which was more than 33 patients($29\%$) with such pain. The cure rate was high in the patients without migraine than with migraine as a raito of 64 to $46\%$. 8. Most of duration from attack to admission were in a week as 86 cases($75\%$) and the patients with duration over 4 weeks 11 cases($10\%$). The cure rate of the patients in a week, was 54 cases($60\%$) and the patients over 4 weeks was none($0\%$), which meant shorter the duration was, the beter the result was. 9. Response on electro acupuncture on initiating therapy showed good in 39 cases($34\%$) the majority group, moderate in 37 cases, exellent in 29 cases and poor in 5 cases. 10. The results of treatment were as follows : asymptomatic in 58 cases($51\%$), improved n 40cases($35\%$), effective in 10 cases($9\%$) and ineffective in 6 cases($5\%$). 11. Cure rate according to the response on electro acupuncture showed $72\%$ in exellent group, $59\%$ in good group, $27\%$ in moderate groop, and $0\%$ in poor group. These show the better the response on the electro-acupuncture is, the higher the cure rate is, which will be able to indicate the prognosis of facial paralysis.

• 한방안이비인후피부과학회지
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• 제14권2호
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• pp.262-270
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• 2001

1. Five Clinical tests and case studies show that facial palsy can be improved under the treatment of Acupuncture, Infrared, Electroacupuncture. Herbal medicine and Herbal acupuncture. 2. The most common prodrome appears to be postauricular pain. including headache and dizziness. 3. As the more serious the paralysis becomes. the prodrome gets worse, and the treatment term extends. It also gets harder to perform prognosis 4. We confirm that either physical or mental overwork and stress can be the most likely cause of facial palsy.

• 대한한방내과학회지
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• 제38권5호
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• pp.769-777
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• 2017

Objective: Facial nerve palsy is caused by damage to the 7th cranial nerve. It is the main symptom of facial muscle paralysis on the affected side. Usually, recovery from this disease begins 2-3 weeks after onset and most patients recover in 4-8 weeks. If the patients cannot receive proper treatment, severe permanent impairments, both physical and mental, may remain, so this disease should be treated appropriately. In this study, a patient with facial nerve palsy was admitted to the Korean medicine hospital for treatment. We report on the patient's progress and the effects of treatment. Methods: We cured the patient with herbal medicines, acupuncture, herbal acupuncture therapy, and physical therapy. We used a numerical rating scale, the House Brackmann grading system, and a weighted regional grading system to assess symptom changes. Result: The patient with facial nerve palsy was hospitalized for 23 days and recovered from symptoms without significant problems on the face or in motor function.

• 대한한방내과학회지
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• 제30권1호
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• pp.129-143
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• 2009

Objective : This study was aimed to investigate the general features and differences between obesity and skinniness of patients with Bell's palsy. Methods : We measured the sex, age. BMI. pulse diagnosis and HBGS (House-Brackmann Grading System) of 234 patients who were diagnosed with Bell's palsy. Results and Conclusions : The results with statistical significance were as follows (1) The distribution of age revealed that 40s was the most at 30.8 %: (2) The improvement period in facial palsy patients with sub-paralysis was shorter than whole-paralysis. And in one part the more we treated, the shorter the improvement period was: (3) In distribution of fat rate in facial palsy patients, obesity was the most at 61.37%, low weight 15.88%. So we found that the fatter the patients was. the higher the onset rate was: (4) In distribution of pulse diagnosis in facial palsy patients with obesity. the ratio of Xu mai (虛脈) was 67.06%. Shi mai (實脈) 32.94%. The Xu mai was similar to Qi xu (氣虛). So we found that the facial palsy patients with obesity were more Qi xu than with low weight. In distribution of pulse diagnosis in facial palsy patients with skinniness, the ratio of Chi mai (遲脈) was none. Shuo mai (數脈) was most: (5) In distribution of region in facial palsy patients with obesity-Xu mai. the ratio of left was 45.10%, right 54.90%, but this result was not statistically significant.

• 대한물리치료과학회지
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• 제5권3호
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• pp.643-650
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• 1998

저자들은 1996년 3월부터 1997년 3월까지 계명대학교 동산의료원 물리치료실에서 치료를 받은환자 중 안면신경 마비 증세를 나타낸 39례에 대하여 임상적인 고찰을 시행하여 다음과 같은 결과를 얻었다. 1) 연령별로는 30대에서 10례(24.6%)로 가장 많았다. 2) 성별로는 남자 21례(53.8%), 여자 18례(46.2%)였다. 3) 발생부위는 우측 19례(48.7%), 좌측 18례(46.2%)였다. 4) 발생원인별로는 원인불명(Bell's palsy) 19례(48 7%), 염증, 종양 각 6례(15.4%), 외상성 5례(12.9%), 대사성 2례(5.1%), 선천성 1례(2.6%)였다. 5) 병변의 발생에서 최초 치료일까지의 기간은 10일 이내가 26례(66.7%), 11-20일은 8례 (20.5% )였다. 6) 치료기간은 평균 25.21이며, 치료기간과 회복율의 상관관계는 통계학적 유의성은 없었다. 7) 치료 후 치료결과는 상당히 좋은 것으로 나타났다.

• Archives of Plastic Surgery
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• 제49권4호
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• pp.523-526
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• 2022

Salivary duct carcinoma is a rare malignant salivary gland tumor that mainly has solid features. When it occurs in the parotid gland, it can invade the facial nerve and cause facial nerve paralysis. However, in our case, the salivary duct carcinoma exhibited cystic features on computed tomographic imaging, and the facial nerve passed through the cyst. Total parotidectomy with level-I to -III dissections was performed and nerve passing through the tumor was sacrificed. The patient received postoperative radiotherapy and was clinically and radiologically followed-up for every 3 months. Recurrence or distant metastasis was not reported. To the best of our knowledge, this is the first case involving a salivary duct carcinoma with cystic features and facial nerve invasion. Here, we report a first case of cystic salivary duct carcinoma of the parotid gland which uncommonly undergo cystic change and penetrated by facial nerve and successfully resected without causing facial nerve injury.