• Journal of Audiology & Otology
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• 제23권4호
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• pp.204-209
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• 2019

For a minimally invasive approach to access the facial nerve, we designed an extended epitympanotomy via a transmastoid approach that has proven useful in cases of traumatic facial nerve palsy and pre-cholesteatoma. To evaluate the surgical exposure through an extended epitympanotomy, six patients with traumatic facial nerve palsy were enrolled in this study. The same surgical technique was used in all patients. Patients were assessed and the degree of facial nerve paralysis was determined prior to surgery, 1-week post-operatively, and 6-months post-operatively using the House-Brackmann grading system. In all cases, surgical exposure was adequate. All patients with traumatic facial nerve palsy were male and the age range was 13 to 83 years. In all cases, the location of the facial nerve damage was limited to the area between the first and second genu. Symptoms of all the patients improved by 6 months post-operation (p=0.024). There were no complications in any of the patients. Extended epitympanotomy is useful for safe, rapid surgical exposure of the attic area, sparing the patient post-operative dimpling, skin incision complications, and lengthy exposure to anesthesia. We suggest that surgery for patients with facial nerve palsy secondary to trauma be performed using this described technique.

• 대한청각학회지
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• 제23권4호
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• pp.204-209
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• 2019

For a minimally invasive approach to access the facial nerve, we designed an extended epitympanotomy via a transmastoid approach that has proven useful in cases of traumatic facial nerve palsy and pre-cholesteatoma. To evaluate the surgical exposure through an extended epitympanotomy, six patients with traumatic facial nerve palsy were enrolled in this study. The same surgical technique was used in all patients. Patients were assessed and the degree of facial nerve paralysis was determined prior to surgery, 1-week post-operatively, and 6-months post-operatively using the House-Brackmann grading system. In all cases, surgical exposure was adequate. All patients with traumatic facial nerve palsy were male and the age range was 13 to 83 years. In all cases, the location of the facial nerve damage was limited to the area between the first and second genu. Symptoms of all the patients improved by 6 months post-operation (p=0.024). There were no complications in any of the patients. Extended epitympanotomy is useful for safe, rapid surgical exposure of the attic area, sparing the patient post-operative dimpling, skin incision complications, and lengthy exposure to anesthesia. We suggest that surgery for patients with facial nerve palsy secondary to trauma be performed using this described technique.

• 대한두개안면성형외과학회지
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• 제22권6호
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• pp.303-309
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• 2021

Background: Transferring the hypoglossal nerve to the facial nerve using an end-to-end method is very effective for improving facial motor function. However, this technique may result in hemitongue atrophy. The ansa cervicalis, which arises from the cervical plexus, is also used for facial reanimation. We retrospectively reviewed cases where facial reanimation was performed using the ansa cervicalis to overcome the shortcomings of existing techniques of hypoglossal nerve transfer. Methods: The records of 15 patients who underwent hypoglossal nerve transfer were retrospectively reviewed. Three methods were used: facial reanimation with hypoglossal nerve transfer (group 1), facial nerve reanimation using the ansa cervicalis (group 2), and sural nerve interposition grafting between the hypoglossal nerve and facial nerve (group 3). In group 1, the ansa cervicalis was coapted to neurotize the distal stump of the hypoglossal nerve in a subset of patients. Clinical outcomes were evaluated using the House-Brackmann (H-B) grading system and Emotrics software. Results: All patients in group 1 (n= 4) achieved H-B grade IV facial function and showed improvements in the oral commissure angle at rest (preoperative vs. postoperative difference, 6.48° ± 0.77°) and while smiling (13.88° ± 2.00°). In groups 2 and 3, the oral commissure angle slightly improved at rest (group 2: 0.95° ± 0.53°, group 3: 1.35° ± 1.02°) and while smiling (group 2: 2.06° ± 0.67°, group 3: 1.23° ± 0.56°). In group 1, reduced tongue morbidity was found in patients who underwent ansa cervicalis transfer. Conclusion: Facial reanimation with hypoglossal nerve transfer, in combination with hypoglossal nerve neurotization using the ansa cervicalis for complete facial palsy patients, might enable favorable facial reanimation outcomes and reduce tongue morbidity. Facial reanimation using the ansa cervicalis or sural nerve for incomplete facial palsy patients did not lead to remarkable improvements, but it warrants further investigation.

• 대한한방내과학회지
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• 제43권5호
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• pp.827-837
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• 2022

Objectives: The purpose of this study is to investigate the effectiveness of using Korean medical treatment for peripheral facial nerve palsy. Methods: We primarily treated the patient's peripheral facial nerve palsy during hospitalization (06/28/21~07/13/21) without any other steroids or antiviral drug treatments and additionally treated their spinal stenosis, using Korean medical treatments in both cases (herbal medicine, acupuncture, and herbal acupuncture therapy). The House-Brackmann grading system and Yanagihara's unweighted grading system were used to assess facial symptom changes, and the Numerical Rating Scale was used to evaluate the back pain caused by the spinal stenosis. Results: Following treatment, the patient's House-Brackmann and Numerical Rating Scale scores decreased, while their Yanagihara unweighted score improved. Conclusions: This study suggests that Korean medicine may be effective in the treatment of facial nerve palsy.

• 대한한방내과학회지
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• 제44권5호
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• pp.929-940
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• 2023

Objectives: This study reports on the efficacy of Korean medicine treatments for peripheral facial nerve palsy and sleep disorders that occur after microvascular decompression. Methods: A 57-year-old female patient with right facial palsy was treated with herbal medicines and acupuncture for 36 days. The treatment effect was evaluated using the House Brackmann Grading System (HBGS), Yanagihara's Unweighed Grading System (Yanagihara's score), and the Korean Modified Leeds Sleep Evaluation Questionnaire (KMLSEQ). Results: Following treatment, the patient showed a decrease in HBGS and an improvement in Yanagihara's score and KMLSEQ score. Conclusions: Korean medicine treatments appeared to be effective in reducing facial nerve palsy. Further clinical research on patients with facial nerve palsy is needed.

• 대한한방내과학회지
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• 제40권5호
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• pp.785-796
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• 2019

Objective: Facial nerve palsy causes both facial muscle malfunction and mental illness. Because a facial nerve palsy lesion shows on the face, it can have serious effects on social relationships and mental health. Many facial nerve palsy patients undergo anxiety, depression, and social phobia. In this study, a facial nerve palsy patient with sleep disorder was admitted to the Korean medicine hospital for treatment. Methods: The patient with facial nerve palsy and sleep disorder was treated with herbal medicines, acupuncture, herbal acupuncture therapy, and physical therapy. We used the House Brackmann grading system and Yanagihara's Unweighted Grading System to assess changes in facial nerve palsy symptoms and the Korean Modified Leeds Sleep Evaluation Questionnaire to assess the sleep disorder. Results: The patient was hospitalized for 18 days and showed a recovery from both facial nerve palsy and sleep disorder symptoms without any adverse events. We conclude that patients with facial nerve palsy should be treated from both the physical and mental health perspectives.

• 대한한방내과학회지
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• 제39권2호
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• pp.277-285
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• 2018

Objective: This study is designed to evaluate the effects of Korean medicine treatment for facial nerve palsy. Method: The patient was administered Korean medicine treatment, including acupuncture, pharmacopuncture, and herbal medicine. We used the House-Brackmann Grading System and Yanagihara's Unweighted Grading System to assess the symptoms of facial nerve palsy. Results: The patient's House-Brackmann grade was reduced from grade IV to grade II, and Yanagihara's grade was increased from 19 to 32. The patient's symptoms, which were facial pain, facial asymmetry, reduced wrinkling forehead, incomplete closing eye, epiphora, and tinnitus, improved during the hospitalization. Conclusion: This study shows that Korean medicine treatment may be an effective treatment for facial nerve palsy.

• 척추신경추나의학회지
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• 제16권2호
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• pp.87-95
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• 2021

Objectives This study aimed to investigate the effect of SJS non-resistance technique-facial palsy (SJSNRT-F) using Korean medicine treatment on facial nerve palsy through three case studies. Methods SJSNRT-F, with other Korean medicine treatments, was performed on three patients who underwent treatment at OO Korean Medicine Hospital from March 2021 to August 2021. Additionally, the House-Brackmann grading system (H-B grade) and Yanagihara's unweighted grading system (Yanagihara's score) were evaluated in these patients. Results There was a significant increase in the Yanagihara scores. Except for one patient who was discharged early, two patients showed improvement in the H-B grade. Conclusions This study suggests that Korean medicine treatment including SJSNRT-F may affect the treatment of facial nerve palsy. However, better clinical studies are needed to confirm the same.

• Journal of Korean Neurosurgical Society
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• 제60권2호
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• pp.165-173
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• 2017

Objective : To explore and analyze the influencing factors of facial nerve function retainment after microsurgery resection of acoustic neurinoma. Methods : Retrospective analysis of our hospital 105 acoustic neuroma cases from October, 2006 to January 2012, in the group all patients were treated with suboccipital sigmoid sinus approach to acoustic neuroma microsurgery resection. We adopted researching individual patient data, outpatient review and telephone followed up and the House-Brackmann grading system to evaluate and analyze the facial nerve function. Results : Among 105 patients in this study group, complete surgical resection rate was 80.9% (85/105), subtotal resection rate was 14.3% (15/105), and partial resection rate 4.8% (5/105). The rate of facial nerve retainment on neuroanatomy was 95.3% (100/105) and the mortality rate was 2.1% (2/105). Facial nerve function when the patient is discharged from the hospital, also known as immediate facial nerve function which was graded in House-Brackmann : excellent facial nerve function (House-Brackmann I-II level) cases accounted for 75.2% (79/105), facial nerve function III-IV level cases accounted for 22.9% (24/105), and V-VI cases accounted for 1.9% (2/105). Patients were followed up for more than one year, with excellent facial nerve function retention rate (H-B I-II level) was 74.4% (58/78). Conclusion : Acoustic neuroma patients after surgery, the long-term (${\geq}1year$) facial nerve function excellent retaining rate was closely related with surgical proficiency, post-operative immediate facial nerve function, diameter of tumor and whether to use electrophysiological monitoring techniques; while there was no significant correlation with the patient's age, surgical approach, whether to stripping the internal auditory canal, whether there was cystic degeneration, tumor recurrence, whether to merge with obstructive hydrocephalus and the length of the duration of symptoms.

• Journal of Acupuncture Research
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• 제41권1호
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• pp.53-62
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• 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.