• 대한두개안면성형외과학회지
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• 제21권4호
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• pp.244-248
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• 2020

The infraorbital nerve is a branch of the trigeminal nerve. Injury to the infraorbital nerve can be caused by trauma, including various facial fractures. Due to this nerve injury, patients complain of numbness and pain in the entire cheek, the ala of nose, and upper lip. In general, spontaneous sensory recovery is expected after decompressive surgery. If nerve transection is confirmed, however, neurorrhaphy is typically performed. Here, we present a case in which microsurgery was not performed in a patient with Sunderland grade V avulsion injury of the infraorbital nerve due to a facial bone fracture. Gradual nerve function recovery was confirmed to be possible with conservative treatment and rehabilitation alone. These findings suggest that the nerve function recovery can be expected with conservative treatment, even for severe nerve injury for which microsurgery cannot be considered.

• 대한치과의사협회지
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• 제55권8호
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• pp.537-540
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• 2017

BSSRO (bilateral sagittal split ramus osteotomy) is frequently performed to correct dentofacial deformity and malocclusion. Among its complications the incidence of post-operative facial nerve palsy is very rare, but it is one of the most serious complications. The case of a 21-year-old male patient who underwent facial nerve palsy after BSSRO is described. After surgical intervention and conservative therapy, the patient recovered his facial nerve function successfully.

• The Korean Journal of Pain
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• 제5권2호
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• pp.263-268
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• 1992

Ramsay Hunt 증후군으로 확진된 환자 2예를 경험하였다. 첫 예인 경우 안면신경마비가 발생하던 날 바로 방문하여 대상포진에 대한 치료와 환측 성상신경절 차단 15회, TENS, 안면운동 훈련 반복 등으로 발병 후 3주만에 완전 치유 되었으며, 두번째 환자는 발병 후 7주일 후에 방문하여 대상포진에 대한 치료는 생략하고 안면신경마비에 대한 치료라고 사료되는 환측 성상신경절 차단 50회, TENS 수백회, 안면운동 훈련 반복시행하였으나 부분적인 회복을 하였을 뿐이다. 그러므로 Ramsay Hunt 증후군의 치료도 다른 여러 질환과 마찬가지로 조기에 치료하면 회복이 빠르고 거의 완전하며, 늦어질수록 예후가 좋지 않다는 것을 경험하였다. 두 예 모두에서 대상포진 후 신경통으로의 이행은 없었다.

• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권2호
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• pp.190-197
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• 2011

The management of mandibular prognathism was revolutionized by the advent of the of sagittal split ramus osteotomy (SSRO) technique as described by Obwegesser and Trauner in 1957. Facial nerve palsy following SSRO is a rare but serious problem. In the event of post-operative facial palsy, careful clinical and neurophysiological investigations such as a nerve condunction test for facial function is mandatory. The authors examined patients with facial palsy following SSRO. Patients recovered after 3~4 months and we had performed clinical examinations with electromyography and nerve conduction tests during follow-up period.

• Annals of Clinical Neurophysiology
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• 제3권2호
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• pp.122-127
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• 2001

Background : Bell's palsy(BP) is defined as an idiopathic peripheral facial paralysis of sudden onset and account more than 50% of facial paralysis. It's etiology is unclear, but herpes simplex virus type-1(HSV-1) has been the most suspicious causative agent of BP that ever been studied. We evaluated the effect of add-on acyclovir in acute stage of BP. Methods : Subject consisted of 35 patients who developed acute idiopathic unilateral facial nerve palsy(16 men and 19 women with age 9-78 years old). The treatments were started within 10 days after onset of BP. Facial nerve function was assessed by the House-Brackman facial nerve grading scale and facial nerve conduction study including blink reflex. Follow-up evaluation were made 2 month after onset. Twenty of 35 patients were treated with combined therapy of acyclovir and prednisone. As a control group, 15 patients were treated with prednisone only. We compared the improvement of neurologic defects at recovery phase. Results : Compared with two groups, difference in grading scale at recovery phase is statistically significant(p<0.01). So, acyclovir-prednisone group showed a significant improvement in grading scale at recovery phase compared with prednisone group. Conclusion : We identified the benefits of add-on acyclovir in the acute stage of BP.

• 동의생리병리학회지
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• 제27권3호
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• pp.327-330
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• 2013

The purpose of this study is to report a clinical progress of treatment of sequelae caused by removal of facial schwannoma through Korean medicine. A patient was diagnosed with facial schwannoma by MRI on 4th June 2012 in local university hospital, he had right facial palsy, auditory hypersensitivity, dizziness after removal of facial schwannoma. Between 25th July 2012 and 26th January 2013, he was treated with acupuncture, cupping, electro-acupuncture every week and observed by House-Brackmann facial nerve grading system(H-B scale) and MoReSS every month. He had 29 times treatments. At the first of treatment, his state was Grade IV (H-B scale), 4/8(facial nerve grading), 10 points during action 7 points during rest(MoReSS) and he had severe facial palsy, ill-acrimation, auditory hypersensitivity. At the middle of treatment, October 2012, symptoms improved. State was Grade III (H-B scale), 5/8(facial nerve grading), 7 points during action 3 points during rest(MoReSS). Severe facial palsy improved ; Forehead creasing and union motor function recovered, he was able to close his eyes so ill-acrimation improved. At the end of treatment, January 2012, state was Grade II (H-B scale), 7.5/8(facial nerve grading), 3 points during action 1 point during rest(MoReSS). He had only occasional tinnitus and auditory hypersensitivity. Acupuncture and electro-acupuncture are estimated to be good for facial palsy after removal of facial schwannoma. More cases are required to develop treatment of facial palsy.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권3호
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• pp.428-437
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• 1994

Optic nerve injury serious enough to result in blindness had been reported to occur in 3% of facial fractures. When blindness is immediate and complete, the prognosis for even partial recovery is poor. Progressive or incomplete visual loss may be ameliorated either by large dosage of steroid or by emergency optic nerve decompression, depending on the mechanism of injury, the degree of trauma to the optic canal, and the period of time that elapses between injury and medical intervention. We often miss initial assessment of visual function in management of facial fracture patients due to loss of consciousness, periorbital swelling and emergency situations. Delayed treatment of injuried optic nerve cause permanent blindness due to irreversible change of optic nerve. But by treating posttraumatic optic nerve injuries aggressively, usable vision can preserved in a number of patients. The following report concerns three who suffered visual loss due to optic nerve injury with no improvement after steroid therapy and/or optic nerve decompression surgery.

• Annals of Clinical Neurophysiology
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• 제9권1호
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• pp.5-10
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• 2007

Background: Bell's palsy (BP) is a self-limited rapid onset facial palsy that is non-life-threatening and has a generally favorable prognosis. Facial paralysis can be caused by numerous conditions, all of which should be excluded before the diagnosis of BP is reached. The etiopathogenesis and clinical course of BP are uncertain. So we analyzed the epidemiology and clinical course of BP patients. Methods: The subjects include 100 cases of BP examined during the period of 18 months. Careful clinical history, neurologic examinations, laboratory tests, electrophysiologic studies, and brain imaging were performed. Follow-up examinations were done once a week during the first month and subsequently once a month until normal function was restored or for up to 3 months. Facial nerve function was assessed by House-Brackman (HB) facial nerve grading scale and electrophysiologic studies. Results: Except 13 recurrent BP patients, we analyzed 87 BP patients. Forty-four (50.6%) were men and 43(49.4%) were women and the mean age was 51.0(${\pm}16.6$) years. Three (3.4%) patients showed a familial tendency. The initial examination within 1 week after attack revealed 35.2% was below HB grade 4 and 64.8% was above grade 3. The associated symptoms are as follows; postauricular pain, increase tear flow, taste change, hyperacusis and drooling. The initial facial nerve conduction study and blink reflex within 1 week after attack showed abnormal findings in 12.6% and 100%, respectively. Brain MRI was performed in 59(67.8%) patients and showed abnormal enhancement of affected nerve in 57(96.6%). Follow-up examination showed that 78.2% of the patients partially improved within 4 weeks and completely improved within 3 months. Finally 80.5% of the total patients obtained normal function in 3 months. Conclusions: We report epidemiologic, clinical, electrophysiologic and radiologic characteristics of BP patients.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.43-47
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• 2011

Purpose: Sensory impairment in infraorbital nerve is common symptom following mid-facial fractures. The purpose of this study is to document the incidence of sensory impairment in infraorbital nerve following midfacial fractures and its recovery. Methods: Three hundreds fourteen patients with midfacial fracture were included involving emergence areas of infraorbital nerve. Fractures were classified into zygoma fracture, maxilla fracture, complex comminuted fracture and pure blow out fracture. Neurosensory function was assessed with clinical symptoms and light touch test in infraorbital nerve regions. Patients were followed and sensory function was evaluated immediately, 1, 3 and 6 months after trauma. Results: The total series consisted of 198 zygoma fractures, 19 maxilla fractures, 30 complex comminuted fractures and 67 pure blow out fractures. The incidence of sensory impairment was 60% (63% in zygoma fractures, 84% in maxilla fractures, 93% in complex comminuted fractures, 31% in pure blow out fractures). Persistent sensory impairments were remained in 32% (33% in zygoma fractures, 47% in maxilla fractures, 73% in complex comminuted fractures, 6% in pure blow out fractures) 6 months after trauma. Younger patients had better prognosis than older patients in recovery of infraorbital nerve function ($p$ <0.05, $x^2$-test). Mean recovery time was 11 weeks. Conclusion: The incidence of post-traumatic sensory impairment was different according to fracture types. Age of patients and fracture type were important factors that influence to recovery of sensory impairment. Complex comminuted fracture had poor prognosis, and pure blow out fractures had better prognosis than other fractures.