• Archives of Craniofacial Surgery
• /
• v.10 no.1
• /
• pp.33-36
• /
• 2009

Purpose: Fractures of the mandibular condylar area are common injuries that account for 29% to 40% of fractures of the facial bones and represent 20% to 62% of all mandibular fractures. Currently 3 main methods are being used in the treatment of mandibular subcondylar fractures: closed reduction; open reduction and internal fixation; Endoscopic reduction and internal fixation. Each method has its proponents and opponent as well as advantages and disadvantages, and indications for each vary among surgeons. There are six approaches of open reduction: submandibular, retromandibular, preaurilcular, postauricular, intraoral, transparotid approach. Among them, transparotid approach has been described for subcondylar exposure with dissection in the direction of facial nerve fibers to expose the bone through the parotid gland. This approach carries the risk of a parotid glandular fistula as well as facial nerve injury but has the advantage of being directly over the fracture site. We report safety and efficacy of surgical treatment using a transparotid approach for direct plating. Methods: A 43-year-old man sustained multiple facial bone fractures by driver traffic accident. Mandibular subcondyle was fractured and dislocated internally. We performed open reduction and internal fixation by transparotid approach. Fractured site was fixed by titanium mini plate & screw. We applicated arch bar for approximately 3 weeks. Results: Follow-up length was about 5months. Scar of surgical incision was indistinct, there was no symptoms and signs of facial nerve and parotid gland injury, and maximal mouth opening was measured 49.5 mm. Conclusion: Transparotid approach has high risks of facial nerve and parotid gland injury, but paradoxically it is the most effective technique in saving facial nerve. Open reduction and internal fixation of mandibular subcondylar fracture by transparotid approach with precise and versed procedure, best outcome can be expected.

• Journal of Acupuncture Research
• /
• v.41 no.1
• /
• pp.53-62
• /
• 2024

Background: The aim of this study is to determine the correlation between clinical assessment scales, self-assessment scales, and surface electromyography (SEMG) for facial nerve palsy. Methods: This study assessed 32 cases of facial nerve palsy on the first visit, 11 cases on the second visit, and 9 cases on the third visit to the Korean medicine hospital, university. This study was conducted from October 22, 2022, to December 22, 2022. The patients were evaluated using SEMG, clinical assessment scales, and self-assessment scales 3 times. The House-Brackmann grading systems (HBGS), Yanagihara unweighted grading system (Y-score), facial disability index, numerous rating scale, and accompanying symptoms of facial nerve palsy were used for assessment. Moreover, statistical correlation was analyzed using Pearson correlation. Results: On Visit 1, Significant correlations were observed between the results of SEMG and other clinical assessment scales as well as between SEMG-F (frontalis) and different parts of the Y-score. On Visit 2, significant correlations were observed between the results of SEMG and HBGS as well as between SEMG-F and the detailed parts of the Y-score. On Visit 3, significant correlations were observed only between SEMG-F and the detailed parts of the Y-score. A significant correlation was also observed between the changes in the clinical assessment scales on Visits 1 and 3 and between the changes in SEMG-F and those in the patient self-assessment scales. Conclusion: These findings suggest that SEMG can be used to evaluate facial nerve palsy in conjunction with the use of other clinical assessment scales.

• Annals of Clinical Neurophysiology
• /
• v.6 no.2
• /
• pp.75-79
• /
• 2004

Backgrounds: Electrodiagnostic tests have been developed to estimate the degree of facial nerve injury during the acute phase. Side-to-side amplitude comparison with the affected side expressed as a percentage of the nonaffected side has been one of the most valuable electrophysiologic methods of assessing facial nerve functioning. This study was designed to know whether there is any difference in the side-to-side comparison of amplitudes and terminal latencies of the compound muscle action potentials (CMAP) of the facial muscles in the patients with Bell's palsy. Methods: Electroneurographic recordings with surface electrodes on the frontalis, orbicularis oculi, nasalis, and orbicularis oris muscles were made within 2 weeks post-onset (mean, day 7) in 39 patients. Results: Of the 39 Bell's palsy patients, 38 patients (97.4%) recovered satisfactorily within 6 months. The amplitude of CMAP in all patients was not reduced to 10% or less of that of the contralateral healthy muscle. The correlation of amplitude change between four facial muscles was relatively strong, but the correlation of latency change was weak. When the electroneurographic values were compared in the four muscle groups, the general linear models procedure did not show any significant difference for CMAP amplitude and latency changes (p=0.62-0.63). Conclusions: This study did not show any significant clinical advantage of electroneurographic recordings in more than one facial muscle at the early stage of Bell's palsy.

• The Korean Journal of Pain
• /
• v.10 no.1
• /
• pp.97-100
• /
• 1997

We treated a 56 year old male ailing of painful herpetic eruption on his 2nd, 3rd and 4th left cervical spinal segment. On the 18th day, patient also suffered an abrupt left facial palsy, accompanied with ongoing postherpetic neuralgia even though the skin eruption had been cured. This patient visited our pain clinic on his 46th day of illness and was teated with continuous cervical epidural block for 9 days, and stellate ganglion block plus oral analgesics and antidepressant for 12 days. The combination of treatments resulted in marked improvement of facial palsy and postherpetic neuralgia. A possible explanation of facial palsy accompanied with herpes zoster on cervical spinal segment could be related to Hunt's hypothesis that geniculate ganglion forms a chain connecting the high cervical ganglion below. Another possibility may be related to a compression injury of the facial nerve by long-term severe edema on the soft tissue of the face, the periauricular area and parotid gland around the facial nerve, and edema on the facial nerve itself emerging out from the cranium.

• The Journal of Internal Korean Medicine
• /
• v.24 no.2
• /
• pp.395-401
• /
• 2003

Facial nerver paralysis is classified as Supranuclear, Peripheral and Nuclear. It is mostly Spontaneous Peripheral Facial Paralysis(Bell's palsy) or Supranuclear Paralysis by C.V.A, but Nuclear Facial Nerve Paralysis is rarely reported. We treated a 64-years-old female patient who had 7-years history of C.V.A with hypertension and heart disease, and complained of these symptoms; left facial palsy, ocular dysmetria, diplopia, and right extremity weakness. We diagnosed as direct attack from the wind pathogen(風邪入中) with deficiency of both Gi(Qi, vital energy) and blood(氣血雨虛), and employed Oriental medical treatments; herb-medication, acupuncture and moxa therapy. The result was relatively acceptable. So We report this case with a brief review of related literatures.

• Journal of Acupuncture Research
• /
• v.39 no.1
• /
• pp.70-75
• /
• 2022

Two patients with sequelae of peripheral facial nerve palsy were treated with Facial Chuna Manual Therapy (FCMT) and acupuncture over 6 months. The House-Brackmann (HB) scale, facial nerve grading system 2.0 (FNGS), the scale of Peitersen, the scale of Murata, and the Numeric Rating Scale (NRS) were used to assess the effects of treatment. The HB scale, FNGS and NRS scores showed improvement for both patients (Case 1: HB scale 5 to 3, FNGS 4 to 2, NRS 10 to 5; Case 2: HB scale 5 to 3, FNGS 4 to 3, NRS 10 to 2.5) following 6 months of treatment. The scores for the Peitersen and Murata scales showed improvement over 6 months in Case 1 (Peitersen 2 to 1, Murata 10 to 7), but there was no change in Case 2 over the test period (4 months). FCMT and acupuncture may help patients with sequelae of facial palsy.

• Korean Journal of Clinical Laboratory Science
• /
• v.50 no.4
• /
• pp.470-476
• /
• 2018

Facial motor evoked potential (FMEP) by multi-pulse transcranial electrical stimulation (mpTES) can complement free-running electromyography (EMG) and direct facial nerve stimulation to predict the functional integrity of the facial nerve during cerebello-pontine angle (CPA) tumor surgery. The purpose of this paper is to examine the standardized test methods and the usefulness of FMEP as a predictor of facial nerve function and to minimize the incidence of facial paralysis as an aftereffect of surgery. TES was delivered through electrode Mz (cathode) - M3/M4 (anode), and extracranially direct distal facial muscle excitation was excluded by the absence of single pulse response (SPR) and by longer onset latency (more than 10 ms). FMEP from the orbicularis oris (o.oris) and the mentalis muscle simultaneously can improve the accuracy and success rate compared with FMEP from the o.oris alone. Using the methods described, we can effectively predict facial nerve outcomes immediately after surgery with a reduction of more than 50% of FMEP amplitude as a warning criterion. In conclusion, along with free-running EMG and direct facial nerve stimulation, FMEP is a useful method to reduce the incidence of facial paralysis as a sequela during CPA tumor surgery.

• Journal of Acupuncture Research
• /
• v.33 no.2
• /
• pp.211-220
• /
• 2016

Objectives : Facial nerve palsy is a rare but well-known complication that occurs after a tooth extraction. The paralysis follows the injection of a local anesthetic, but patients typically recover after a few hours. However, there are a number of reports of delayed paralysis, and the cause of delayed facial palsy remains uncertain. This study is the first case report detailing how Korean medicine can be used to treat facial nerve palsy following tooth extraction. This study reports our experience of a patient's favorable recovery. Methods : A 25-year-old male patient experienced acute facial palsy after four premolar teeth were extracted. He was hospitalized in the Pusan National University Korean Medical Hospital. We provided complex Korean traditional medical treatments such as acupuncture, cupping, use of a hot water steamer, and herbal medicine for 18 days. Results : Using the Yanagihara Grading Score, we found improvements in the patient's voluntary facial movement as his score increased from 22 to 34. Furthermore, his accompanying symptoms, such as dry eye and facial pain, disappeared. However, the patient reported transient pain around acupoints after the acupuncture intervention. Conclusion : Our study suggests that Korean medical treatments might be effectively used to treat facial nerve palsy after tooth extraction, although further research should be conducted due to the limited number of cases in this area.

• Journal of Acupuncture Research
• /
• v.18 no.3
• /
• pp.10-22
• /
• 2001

Objective : Many methods have been used for treatment of facial nerve paralysis. The purpose of this study was to evaluate the clinical difference between acupuncture therapy and acupuncture-oriental herb medicine therapy. Materials and Methods : From 05-01-2000 to 01-30-2001, 46 facial paralysis patients who were hospitalzed and treated more than five times at the Department of Acupuncture & Moxibustion of Dongguk University Bundang Oriental Medical Hospital were selected for two group. One group(A group) was treated by acupuncture therapy, the other group(B group) was treated by acupuncture and oriental herb medicine therapy. A group was composed of 15 patients and B group was 31 patients. Results and Conclusion : As the results of study, both acupuncture therapy and acupunture-oriental herb medicine therapy were usable for facial nerve paralysis treatment. But, we could not discover any available difference between acupuncture therapy group and acupuncture-oriental herb medicine therapy group.

• Korean Journal of Head & Neck Oncology
• /
• v.16 no.2
• /
• pp.187-190
• /
• 2000

Parotidectomy, combined with neck dissection, is not rare situation in case of parotid malignancy. It is common to accomplish the parotidectomy and neck dissection separately. But there are numerous lymph nodes surrounding the marginal mandibular branch of facial nerve and facial artery and vein. And so, Mono-bloc dissection of the parotid gland and neck specimen is neccessary to completely resect these lymph nodes with preserving the marginal mandibular branch of facial nerve. We are reporting three cases of mono-bloc dissection of the parotid gland and neck specimen.