• Archives of Plastic Surgery
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• 제34권3호
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• pp.325-329
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• 2007

Purpose: Mobius syndrome is a rare congenital disorder characterized by facial diplegia and bilateral abducens palsy, which occasionally combines with other cranial nerve dysfunction. The inability to show happiness, sadness or anger by facial expression frequently results in social dysfunction. The classic concept of cross facial nerve grafting and free muscle transplantation, which is standard in unilateral developmental facial palsy, cannot be used in these patients without special consideration. Our experience in the treatment of three patients with this syndrome using transfer of muscles innervated by trigeminal nerve showed rewarding results. Methods: We used bilateral temporalis muscle elevated from the bony temporal fossa. Muscles and their attached fascia were folded down over the anterior surface of the zygomatic arch. The divided strips from the attached fascia were passed subcutaneously and anchored to the medial canthus and the nasolabial crease for smiling and competence of mouth and eyelids. For the recent 13 years the authors applied this method in 3 Mobius syndrome cases- 45 year-old man and 13 year-old boy, 8 year-old girl. Results: One month after the surgery the patients had good support and already showed voluntary movement at the corner of their mouth. They showed full closure of both eyelids. There was no scleral showing during eyelid closure. Also full closure of the mouth was achieved. After six months, the reconstructed movements of face were maintained. Conclusion: Temporalis muscle transfer for Mobius syndrome is an excellent method for bilateral reconstruction at one stage, is easy to perform, and has a wide range of reconstruction and reproducibility.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권2호
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• pp.143-149
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• 2020

Objectives: Long-term facial paralysis results in degeneration of the distal nerve segment and atrophy of the supplied muscles. Options for these patients include free muscle transfer, temporalis myoplasty, and botulinum toxin injections for smile reanimation. In this study we aimed to evaluate the subjective and objective outcomes of these procedures. Materials and Methods: In our study, we retrospectively analyzed smile symmetry in patients with facial palsy (n=8) who underwent facial reanimation procedures. Results: Subjective analysis showed high satisfaction in seven out of eight patients. Objective analysis showed statistically significant improvement postoperatively in both vertical and horizontal smile symmetry at rest and during maximum smile (P<0.001). Conclusion: Choosing the ideal procedure for the patients is the most critical aspect for facial reanimation. Though free muscle transfer is considered gold standard procedure, temporalis myoplasty also gives satisfactory results. Residual synkinesis which can lead to disturbing aesthetic deformity can be effectively treated with botulinum toxin.

• Archives of Plastic Surgery
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• 제47권5호
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• pp.382-391
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• 2020

Facial palsy has a broad clinical presentation and the effects on psychosocial interaction and facial functions can be devastating. Pediatric facial palsy, in particular, introduces unique familial and technical considerations as anatomy, future growth potential, and patient participation influence treatment planning. Though some etiologies of pediatric facial palsy are self-limiting, congenital and long-standing facial palsies pose difficult challenges that require a combination of surgical, adjunctive, and rehabilitative techniques to achieve facial reanimation. Given the spectrum of ages and symptom severity, as well as the various surgical options available for facial palsy, a tailored approach needs to be developed for each child to restore facial balance and function. Here, we review the etiologies, workup, and treatment of pediatric facial palsy and present our novel algorithmic approach to treatment.

• 만화애니메이션 연구
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• 통권33호
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• pp.383-402
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• 2013

본 연구에서는 감성 변화에 따라 나타나는 얼굴 표정에 대한 해부학적 접근방식으로 근육 체계에 의해서 부호화하는 얼굴 움직임 부호화 시스템(FACS, Facial Action Coding System)을 얼굴표정에 적용하고 이를 바탕으로 듀센스마일(Duchenne smile)을 가상 캐릭터에 적용하여 검증해 보고자 한다. 인간의 표정을 인식하는 방식이 동일하게 가상의 캐릭터에도 적용된다는 선행연구를 바탕으로 애니메이션, 게임 등의 캐릭터에 보다 사실적인 표정을 담을 수 있는 연구 방식을 제안하고자 한다. 실험을 위해 훈련된 연극전공 학생들에게 정서 유발 실험을 통해 듀센 스마일과 일반 스마일을 추출하였다. 추출된 표정을 바탕으로 얼굴 근육 데이터를 표집하여 입과 입술주변의 근육과 다른 부위의 얼굴 표정 빈도를 산출하여 얻어진 데이터를 가상 캐릭터에 적용해 보았다. 그 결과 미소 표정에서 근육의 움직임은 협골 대근육의 수축으로 인한 입술 끝이 상향운동을 하며 안륜근이 수축하며 뺨이 올라가고 눈의 아래쪽 외측 눈꺼풀이 올라가는 표정이 나타났다. 개방성과 관련된 입주변 근육(AU25, AU26, AU27)과 코주위 근육(AU9)이 함께 협골근과 광대근 주변 근육의 움직임이 표현되었다. 그중 듀센 미소는 협골 대근육과 안륜근이 동시에 움직이는 형태로 발생되었다. 이를 바탕으로 본인의 의지에 의해 수행 가능한 광대근육과 감성적 정서에 공감하여 웃음의 형태로 나타나는 안륜근을 구분하고 이를 가상의 캐릭터의 근육에 적용하여 인간의 표정과 가상의 캐릭터 표정이 서로 구분 가능한지를 설문을 통해 알아보고자 하였다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권5호
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• pp.473-479
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• 2008

Asians tend to have prominent mandibular angle. The causes of wide lower third of the facial contour are obtuse mandibular angle and hypertrophy of masseter muscles. In cases of hypertrophy of masseter muscles, conventional treatment intends to the contraction of masseter muscle. Recently, volumetric reduction of masseter muscles using botulinum toxin type A injection and radiofrequency (RF) reduction have been introduced. The use of RF energy for masseter muscle reduction is known as a safe, simple, and effective method for aesthetic lower facial contouring. The purpose of this study is to present the effects of RF reduction applied to hypertrophy of masseter muscles, to review and to encourage RF practices in oral and maxillofacial region.

• 대한한의학회지
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• 제37권2호
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• pp.45-52
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• 2016

Objectives: The purpose of this study is to evaluate the clinical effects of Muscle Energy Technique(MET) for peripheral facial paralysis. Methods: 60 Patients were divided into two groups. Group A(n=30) received the treatment with existing Korean medicine. Group B(n=30) received the MET with existing Korean medicine. It was performed once a day, five time per a week for three weeks. we analyzed Yanagihara's score and House-Brackmann scale Results: A week after MET treatment, Yanagihara's score average of Group A is $7.17{\pm}6.34$. Yanagihara's score average of Group B is $8.84{\pm}5.22$. (p=0.72). Two weeks after MET, Yanagihara's score average of Group A is $12.39{\pm}4.94$. Yanagihara's score average of Group B is $15.12{\pm}3.20$. (p=0.04). Three weeks after MET, Yanagihara's score average of Group A is $17.11{\pm}5.31$. Yanagihara's score average of Group B is $22.78{\pm}3.67$. (p=0.01). A is $3.87{\pm}1.36$. House-Brackmann Scale average of Group B is $3.64{\pm}1.76$. (p=0.63). Two weeks after MET treatment, House-Brackmann Scale average of Group A is $3.20{\pm}0.97$. House-Brackmann Scale average of Group B is $3.02{\pm}1.03$. (p=0.05). Three weeks after MET, House-Brackmann Scale average of Group A is $2.84{\pm}1.12$. House-Brackmann Scale average of Group B is $2.23{\pm}0.78$. (p=0.04). Conclusion: MET treatment is effective for improve the symptoms of peripheral facial paralysis. Therefore, it will be used to peripheral facial paralysis.

• Journal of Acupuncture Research
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• 제41권1호
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• pp.63-68
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• 2024

Background: Facial nerve palsy presents a significant healthcare challenge, impacting daily life and social interactions. This systematic review investigates the potential utility of ultrasonography as a diagnostic tool for facial nerve palsy. Methods: Electronic searches will be conducted across various databases, including MEDLINE, EMBASE, CENTRAL (Cochrane Central register of Controlled Trials), CNKI (China National Knowledge Infrastructure), KMBASE (Korean Medical Database), ScienceON, and OASIS (Oriental Medicine Advanced Searching Integrated System), up to February 2024. The primary outcome will focus on ultrasonography-related parameters, such as facial nerve diameter and muscle thickness. Secondary outcomes will encompass clinical measurements, including facial nerve grading scales and electrodiagnostic studies. the risk of bias in individual study will be assessed using the Cochrane Risk of Bias assessment tool, while the grading of recommendations, assessment, development, and evaluations methodology will be utilized to evaluate the overall quality of evidence. Conclusion: This study aims to review existing evidence and evaluate the diagnostic and prognostic value of ultrasonography for peripheral facial nerve palsy.

• 대한치과교정학회지
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• 제49권4호
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• pp.254-264
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• 2019

Objective: To evaluate the short-term changes in masticatory muscle activity and mandibular movement patterns after orthognathic surgery in skeletal Class III patients with facial asymmetry. Methods: Twenty-seven skeletal Class III adult patients were divided into two groups based on the degree of facial asymmetry: the experimental group (n = 17 [11 male and 6 female]; menton deviation ${\geq}4mm$) and control group (n = 10 [4 male and 6 female]; menton deviation < 1.6 mm). Cephalography, electromyography (EMG) for the anterior temporalis (TA) and masseter muscles (MM), and mandibular movement (range of motion [ROM] and average chewing pattern [ACP]) were evaluated before (T0) and 7 to 8 months (T1) after the surgery. Results: There were no significant postoperative changes in the EMG potentials of the TA and MM in both groups, except in the anterior cotton roll biting test, in which the masticatory muscle activity had changed into an MM-dominant pattern postoperatively in both groups. In the experimental group, the amount of maximum opening, protrusion, and lateral excursion to the non-deviated side were significantly decreased. The turning point tended to be shorter and significantly moved medially during chewing in the non-deviated side in the experimental group. Conclusions: In skeletal Class III patients with facial asymmetry, the EMG activity characteristics recovered to presurgical levels within 7 to 8 months after the surgery. Correction of the asymmetry caused limitation in jaw movement in terms of both ROM and ACP on the non-deviated side.

• 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.

• 대한치과교정학회지
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• 제36권3호
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• pp.218-227
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• 2006

안면 비대칭 환자의 진단분석에 이용할 수 있는 이하두정 두부방사선 규격사진과 표면 근전도 검사 자료는 통용화된 진단분석법 부재 등의 이유로 제한적으로 사용되고 있다. 그러나 여타 진단분석법과 비교할 때, 수직 안모 유형의 평가 등 차별적인 정보를 얻을 수 있어 이에 대한 연구가 필요하리라 보인다. 본 연구의 목적은 안면 비대칭을 보이는 60명을 대상으로 이하두정 두부방사선 규격사진 및 저작근의 표면 근전도를 측정하여 수직 안모 유형과의 연관성 및 안면 비대칭과의 연관성을 평가하고자 함이다. 이하두정 두부방사선 규격사진 계측치 중 radiographic corpus length는 비편위측이 큰 값을 보였고 (p<0.001), 유의성은 없었으나 gonion to interspinosum axis는 편위측이 크고, gonion과 하악과두의 위치는 비편위측이 편위측에 비해 전방에 위치하였다 (p=0.07). 안정시 편위측 전측 두근의 근활성은 비편위측보다 높은 것으로 나타났다 (p<0.01). 또한 최대 폐구 시 교근의 활성은 유의성이 없었으나 비편위측에 비해 편위측이 큰 값을 보였다 (p<0.09). Facial index와 intercondylar axes angle은 양의 상관관계를 보였다 (p<0.01). 최대 폐구 시 편위측 및 비편위측의 교근의 활성은 facial index와 양의 상관관계를 보였다 (p<0.05). 이상의 결과를 통해 골격성 안면 비대칭을 보이는 환자에서 이하두정 두부방사선 규격사진과 표면 근전도 검사를 통해 비대칭 양상의 평가와 더불어 수직 안모 유형의 평가 또한 가능한 것으로 생각된다.