• Archives of Craniofacial Surgery
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• v.25 no.2
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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.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.2
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• pp.33-48
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• 2013

Objectives : Peripheral nerve injuries are commonly encountered clinical problems and often result in severe functional deficits. Sukjiyanggeun-Tang(shudiyangjin-tang), in oriental medicine, has been used to treat various musculoskeletal disorders. Methods : In the present study, the effects of aqueous extract of Sukjiyanggeun-Tang(shudiyangjin-tang) on functional recovery, severity of pain, and expressions of neurofilament, cycloxygenease-2(COX-2), inducible nitric oxide synthase(iNOS), and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$) following sciatic crushed nerve injury in rats were investigated. For this study, walking tract analysis, plantar test, western blot analysis for COX-2 iNOS, and TNF-${\alpha}$, and Immunofluorescence test for neurofilament were performed. Results : In the present results, sciatic functional index(SFI) in walking tract analysis was significantly decreased following sciatic crushed nerve injury, and pain severity in plantar test was significantly increased. COX-2, iNOS and TNF-${\alpha}$ expressions were increased whereas neurofilament expression was decreased by sciatic crushed nerve injury, In contrast, treatment with Sukjiyanggeun-Tang(shudiyangjin-tang) improved SFI in walking tract analysis and suppressed the pain severity in sciatic crushed nerve injury. Sukjiyanggeun-Tang(shudiyangjin-tang) treatment also suppressed COX-2, iNOS, and TNF-${\alpha}$ expressions and enhanced the neurofilament expression in sciatic crushed nerve injury. Conclusions : In the present study, we have shown that Sukjiyanggeun-Tang(shudiyangjin-tang) is the effective therapeutic modality to ameliorate the symptoms of sciatic crushed nerve injury.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.2
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• pp.17-31
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• 2013

Objectives : Peripheral nerve injuries are commonly encountered clinical problems and often result in serve functional deficit. Bee venom and scolopendra subspinipes have been traditionally used in oriental medicine to treat several inflammatory diseases and chronic pain conditions. Methods : In the present study, the effects of bee venom pharmacopuncture and scolopendra subspinipes pharmacopuncture on functional recovery, severity of pain, and expressions of neurofilament, cycloxygenease-2(COX-2), and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$) following sciatic crushed nerve injury in rats were investigated. For this study, walking tract analysis, plantar test, western blot for COX-2 and TNF-${\alpha}$, and immunohistochemistry for neurofilament were performed. Results : In the present results, sciatic functional index(SFI) in walking tract analysis was significantly decreased following sciatic crushed nerve injury, and pain severity in plantar test was significantly increased. COX-2 and TNF-${\alpha}$ expressions were increased whereas neurofilament expression was decreased by sciatic crushed nerve injury. On the other hand, bee venom pharmacopuncture and scolopendra subspinipes pharmacopuncture improved SFI in walking tract analysis and suppressed the pain severity in sciatic crushed nerve injury. Bee venom pharmacopuncture and scolopendra subspinipes pharmacopuncture suppressed COX-2 and TNF-${\alpha}$ expression and enhanced the neurofilament expression in sciatic crushed nerve injury. Conclusions : In the present study, we have shown that treatment with bee venom or scolopendra subspinipes is the effective therapeutic modality to ameliorate the symptoms of sciatic crushed nerve injury. The efficacies of bee venom and scolopendra subspinipes were similar.

• Journal of Trauma and Injury
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• v.21 no.1
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• pp.66-69
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• 2008

Traumatic bilateral abducens nerve palsy is rare and is associated with intracranial, skull and cervical spine injuries. We report a case of bilateral abducens nerve palsy in a 40-month-old patient with a skull base fracture. The injury mechanism was associated with direct nerve injury caused by a right petrous bone fracture and indirect injury by frontal impact on the abducens nerve at the point of fixation to the petrous portion and Dorello's canal. The emergency physician should be aware of injuries and the mechanism of abducens nerve palsy in head trauma.

• The Journal of Korean Medicine
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• v.31 no.3
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• pp.66-78
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• 2010

Background: Peripheral nerve injuries are a commonly-encountered clinical problem and often result in a chronic pain and severe functional deficits. Objectives: The aim of this study was to evaluate the effects of acupuncture on the descending pain and the recovery of the locomotor function that follows sciatic crushed nerve injury in rats. Method: In order to assess the effects of acupuncture on the descending pain and functional recovery, we investigated the walking track analysis, brain-derived neurotrophic factor (BDNF) and its receptor tyrosine receptor kinase B (TrkB) expression in the sciatic nerve, and on the expressions of c-Fos and nitric oxide synthase in the paraventricular nucleus (PVN) of the hypothalamus and in the ventrolateral periaqueductal gray (vlPAG) region resulting from sciatic crushed nerve injury in rats. Results: Acupuncture treatment at Huantiao (GB30), Yanglingquan (GB34), and Weizhong (BL40) facilitated functional recovery. C-Fos and nitric oxide synthase expressions in the brain and BDNF and TrkB expressions in the sciatic nerve were decreased by acupuncture treatment. The most potent effects of acupuncture were observed at the GB30 acupoint. Conclusion: It is possible that acupuncture can be used for pain control and functional recovery from sciatic nerve injury.

• Journal of International Academy of Physical Therapy Research
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• v.3 no.1
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• pp.345-355
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• 2012

This study purposed to examine the effect of low power laser on pain response and axonal regeneration. In order to prepare peripheral nerve injury models, we crushed the sciatic nerve of Sprague-Dawley rats and treated them with low power laser for 21 days. The rats were divided into 4 groups: normal group(n=10); control group(n=10) without any treatment after the induction of sciatic nerve crush injury; experimental group I(n=10) treated with low power laser(0.21$mJ/mm^2$) after the induction of sciatic nerve crush injury; and experimental group II(n=10) treated with low power laser(5.25$mJ/mm^2$) after the induction of sciatic nerve crush injury. We measured spontaneous pain behavior(paw withdrawal latency test) and mechanical allodynia(von Frey filament test) for evaluating pain behavioral response, and measured the sciatic function index for evaluating the functional recovery of peripheral nerve before the induction of sciatic nerve crush injury and on day 1, 7, 14 and 21 after the induction. After the experiment was completed, changes in the H & E stain and toluidine blue stain were examined histopathologically, and changes in MAG(myelin associated glycoprotein) and c-fos were examined immunohistologically. According to the results of this study, when low power laser was applied to rat models with sciatic nerve crush injury for 21 days and the results were examined through pain behavior evaluation and neurobehavioral, histopathological and immunohistological analyses, low power laser was found to affect pain response and axonal regeneration in both experimental group I and experimental group II. Moreover, the effect on pain response and axonal regeneration was more positive in experimental group I to which output 0.21$mJ/mm^2$ was applied than in experimental group II to which 5.25$mJ/mm^2$ was applied.

• The Journal of Korean Physical Therapy
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• v.19 no.2
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• pp.41-55
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• 2007

Purpose: This study aimed to compare the effect on nerve regeneration of ultrasound irradiation in rats with peripheral nerve injury. Methods: To investigate alterations of the NCAM immunoreactivity in non-crushed part and crushed part of the spinal cord, the unilateral sciatic nerve of the rats were crushed. The expression of NCAM was used as the marked of peripheral nerve regeneration, and also plays an important role in developing nerve system. Experimental animals were sacrificed by perfusion fixation at post-injury 1, 3, 7, 14 days after ultrasound irradiation. The pulsed US was applied at a frequency of 1MHz and a spatial average-temporal average Intensity of 0.5W/of (20% pulse ratio) for 1 mins. The Luxol fast blue-cresyl violet stain were also done to observe the morphological changes. Results: Alteration of NCAM immunoreactivity in the crushed part and the non-crushed part of lower lumbar spinal cord were observed. NCAM-immunoreactivity cells were some increased in the dorsal horn lamina I, III and cell ventral horn at 1 day after unilateral sciatic nerve injury. However, there was not significant difference in the relationship between crushed part and non-crushed part. NCAM-inmmunoreactivity was remarkably increased at 3 days after unilateral sciatic nerve injuryin the gray matter and white matter. NCAM-immunoreactivity was increased in the ventral horn and post horn of experimental crushed part. Also, NCAM-immunoreactivity in large motor neurons in ventral horns lamina VIII, IX were increased at 7 days after unilateral sciatic nerve injury. At 14 days after sciatic nerve crushed injury, there was no significant difference. All group were decreased for 14 days. In the time course of NCAM expression, all groups showed a significant difference at 3day groups(p<0.05). Whereas, CC group was noted a significant difference between 3day and 7 day group respectively. In NCAM expression, there were significantly increased in all group. In the relationship between CNC group and ENC group, significant difference was detected among 3, 7, 14 day group(p<0.05). The difference between CC group and ENC group were noted in all groups(p<0.05). Conclusion: It is consequently suggested that the effects of the ultrasound irradiation may increase the NCAM immunoreactive neurons and glial cell in the spinal cord after unilateral sciatic nerve crushed injury. Therefore, the increased NCAM immunoreactivity in the spinal cord may reflect the neuronal damage and healing process induced by a ultrasound irradiation after peripheral nerve injury in rat.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.4
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• pp.308-316
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• 2006

Objectives Despite considerable advances in technique, experience and skill, the precise place of surgery in the treatment of facial nerve injury remains uncertain. We designed a facial nerve crush injury model in rats and evaluated the recovery of crushed nerve which is the most common injury type of facial nerve using adenovirus vector mediated in vivo gene transfer of Brain derived neurotrophic factor(BDNF). Materials and methods In 48 Sprague Dawley rats, we made a facial nerve crush injury model to main trunk before the furcation, and injected a $10^{11}$pfu adenoviral BDNF in experimental group(BDNF adenoviral injection group; ad-BDNF) and $3{\mu}l$ saline in control group(Saline injection group; saline). After a period of regeneration from 10 to 40 days, nerve regeneration was evaluated with functioinal test (vibrissae and ocular movement), electrophysiologic study(threshold, peak voltage, conduction velocity) and histomorphometric study of axon density. Results Vibrissae and ocular movement, threshold and conduction velocity improved as time elapse in both group, however axon density was increased significantly only in experimental group. Functional test in 10 days and 20 days showed no difference between experimental group and control group. Vibrissae movement, threshold, conduction velocity and axon density in 30 days revealed that the regeneration in quality of experimental group was significantly superior to that of control group. Conclusion In general, there is tendency for nerve regeneration in experimental group (BDNF-adenovirus injection group) during 40 days, functional recovery was detected successfully after facial nerve crush in 30 days postoperatively.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.2
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• pp.115-117
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• 2018

Lingual nerve injury is a rare complication of general anesthesia. The causes of lingual nerve injury following general anesthesia are multifactorial; possible mechanisms may include difficult laryngoscopy, prolonged anterior mandibular displacement, improper placement of the oropharyngeal airway, macroglossia and tongue compression. In this report, we have described a case of bilateral lingual nerve injury that was associated with orotracheal intubation for open reduction and internal fixation of the left distal radius fracture in a 61-year-old woman. In this case, early treatment with dexamethasone effectively aided the recovery of the injured lingual nerve.

• Archives of Plastic Surgery
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• v.33 no.4
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• pp.510-513
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• 2006

Purpose: The Rectus abdominis muscle free flap is utilized in various reconstruction surgeries due to easiness in harvesting, consistency of vascular pedicle and reduced donor site morbidity. But rarely, femoral nerve injury during rectus abdominis harvesting can be resulted. We report a case of femoral nerve injury after rectus muscle harvesting and discuss the injury mechanism with the follow-up process of this injury. Methods: To reconstruct the defect of middle cranial base after wide excision of cystic adenocarcinoma of the external ear, rectus muscle free flap was havested in usual manner. To achieve a long vessel, inferior epigastric artery was dissected to the dividing portion of femoral artery and cut. Results: One week after the surgery, the patient noted sensory decrease in the lower leg, weakness in muscle strength, and disabilities in extension of the knee joint resulting in immobilization. EMG and NCV results showed no response on stimulation of the femoral nerve of the left leg, due to the defects in femoral nerve superior to the inguinal ligament. With routine neurologic evaluations and physical therapy, on the 75th day after the operation, the patient showed improvement in pain, sensation and muscle strength, and was able to move with walking frame. In 6 months after the operation, recovery of the muscle strength of the knee joint was observed with normal flexion and extension movements. Conclusion: Rarely, during dissection of the inferior epigastric artery, injuries to the femoral nerve can be resulted, probably due to excessive traction or pressure from the blade of the traction device. Therefore, femoral nerve injury can be prevented by avoiding excessive traction during surgery.