• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권2호
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• pp.144-154
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• 2001

Dysfunction of the inferior alveolar nerve indicated by various degree of numbness of the lower lip and chin is one of the few drawbacks of mandibular osteotomy, especially Bilateral Sagittal Split Ramus Osteotomy(BSSRO) and genioplasty. Although it has been recorded throughout the history of this techniques, it is true etiology poorly understood. In this study, 22 consecutive patients under class III malocclusiion impression and undergoing orthognathic surgery(BSSRO only 11 case, BSSRO with genioplasty 11 case) were studied using 4 neurosensory test(static light touch, directional discrimination, two-point discrimination, pin pressure nociception) with post OP 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks, 24 weeks, On control group, 10 members without trauma and nerve damage history, nerve test was accomplished. We concluded majority of patients return of sensation during post operative 24 weeks. Althought immediate nerve deficit are 92.2%, 97.2% 88.9% these are recovered to 25%, 35.72%, 10.71% at 24 weeks. Nerve recovery rate increased prominently between post 4 weeks and 8 weeks. There is no statistically difference about neurosensory deficit among the chin area. Neurosensory deficit more severe when the BSSRO with genioplasty group than the only BSSRO group. Immediate neurosensory deficit is larger left side than right side but after 6 months, there is no significantly difference between left side and right side. Static light touch and pin pressure nociception are more sensitive method of neurosensory deficit than two point discrimination.

• Journal of Oral Medicine and Pain
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• 제39권4호
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• pp.133-139
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• 2014

Purpose: There have been reports regarding the various factors associated with the level of discomfort and recovery from neurosensory symptoms in patients with trigeminal nerve injury. However, the contributing factors remain uncertain and poorly understood. The purpose of this paper was to investigate the possible association between various factors expected to affect neurosensory discomfort and recovery in patients with mandibular nerve injury after dental implant surgery. Methods: Eighty-nine post-dental implant surgery patients with mandibular nerve injury were enrolled in this retrospective analysis. A medical records review of the patients was done to determine if the patients' improvement was related to pain intensity, the length of time between the injury and removal of the implant or the depth of penetration of the implant into the mandibular canal as determined by cone-beam computed tomography. Results: There was no significant linear relationship between pain intensity and symptomatic improvement (p=0.319). There was no significant linear relationship between the level of mandibular canal penetration and either pain intensity (p=0.588) or symptomatic improvement (p=0.760). There was a statistically significant linear relationship between length of time before the injury was treated, both with pain intensity (p=0.004), and symptomatic improvement (p=0.024). Conclusions: Our findings indicate that the length of time between nerve injury and initiation of conservative treatment is more closely related to the pain intensity and symptomatic improvement than other factors, including the level of mandibular canal invasion. Additionally, increased pain intensity and decreased symptomatic improvement can be expected over time, because of this linear trend. Therefore, although direct injury to the nerve is the most important factor contributing to a neurosensory disturbances, early neurosensory assessment and initiation of conservative treatment should be done to optimize recovery.

• 대한두개안면성형외과학회지
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• 제25권2호
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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.

• 국제물리치료학회지
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• 제3권2호
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• pp.422-428
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• 2012

The present study purposed to examine the effects of transcutaneous electrical nerve stimulation, self-stretching and functional massage on the recovery of muscle contraction force for muscle fatigue caused by sustained isotonic contraction. The subjects of this study were 45 healthy students. They were divided into transcutaneous electrical nerve stimulation group(n=15), self-stretching group(n=15) and functional massage group(n=15), and using Primus RS. We observed the pattern of changes in maximal voluntary isometric contraction force(MVIC) after causing muscle fatigue in quadriceps femoris muscle through sustained isotonic contraction. Maximal voluntary isometric contraction force(MVIC) were greatly increased after transcutaneous electrical nerve stimulation, self-stretching and functional massage. In the comparison of recovery rate of muscle contraction force for muscle fatigue caused by sustained isotonic contraction among the treatment groups, it did not show any significant differences. However, it showed that each treatment may be effective in recovery of muscle fatigue caused by sustained isotonic contraction.

• 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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권4호
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• pp.339-344
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• 2004

The purpose of this study was to evaluate neurosensory disturbance associated with implant surgery performed by implant practitioner (n=47) composed of trained oral surgeon, periodontist, prosthodontist. The incidence, type and duration of sensory disorder were investigated. Anatomical factor of the patient and experience of operator were also evaluated. The result revealed high incidence of inferior alveolar nerve damage (45%) regardless of experience of implant practitioner. The sensory disturbance sustained within 6 months for 61% of cases, which revealed almost normal recovery of nerve function. Initial neurologic sign after nerve damage was not coincide with their consequence of recovery. Half of the practitioners tried surgical intervention to the implants such as removing the fixture, partial unscrewing or re-implant shorter fixture, of which trial regarded as effective measure for 53% of cases. The result indicates that the objective method of sensory nerve evaluation should be introduced to the implant practitioners and the importance of informed consent for possibility of nerve damage in mandibular implant fixation.

• 한방안이비인후피부과학회지
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• 제22권2호
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• pp.238-250
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• 2009

Recurrence of peripheral nerve palsy is unusual, specially in eye. So there's seldom report about recurrent peripheral nerve palsy in eye. We treated a patient who had consecutive oculomotor nerve palsy after recovery of abducent nerve palsy at right eye. The patient visited our clinic for abducent nerve palsy. When he was hospitalized, ophthalmalgia was VAS 4 but it disappeared when he discharged on 21th of June. Although there was, in the case of abduction of eye, no noticeable change during the hospitalization, it was healed after he received outpatient service twice a week until Nov. 3rd. Oculomotor nerve palsy appeared on 24th of November, 2008 and the patient was hospitalized on Nov. 26th. At that time ophthalmalgia was VAS 4, but disappeared when he discharged. When he entered hospital, the length between upper & lower eyelid and MRD 1 were all 0mm. However, when he discharged, the length between upper & lower eyelid was 11mm, and MRD 1, 4mm which were the same lengths as those of the normal left eye. In the case of eye movement, the motion of supraduction, infraduction, and adduction was entirely inhibited when the patient was hospitalized. By the time of discharge, the inhibition of infraduction was recovered after that of adduction, but the inhibition of supraduction was not recovered. This is a very rare case of peripheral nerve palsy, nevertheless he recovered complete twice by acupuncture and herb medicine therapy.

• 대한후두음성언어의학회지
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• 제12권1호
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• pp.46-54
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• 2001

Background and Objectives : Nitric oxide(NO) is a short-lived molecule with messenger and cytotoxic functions in nervous, cardiovascular, and immune systems. Among the three distinct NOS isoforms, the neuronal isoform is expressed in small, discrete neuronal populations of CNS and PNS. Axonal injury in adult animals results in a dramatic NOS up-regulation in many types of central and peripheral neurons which normally lack the enzyme or express it only at very low levels. In previous study, we confirmed the efficacy of PEMS on the early functional recovery in rats with surgically transected and reanastomosed recurrent laryngeal nerve. Therefore, after we obtained functionally recovered rats using PEMS in this study, we studied to evaluate the expression of nNOS through the analysis of the difference between functional recovery group and non-recovery group in the recurrent laryngeal nerve. Materials and Method : Using 84 healthy male Sprague-Dawley rats, transections and primary anastomosis were performed on their left recurrent laryngeal nerves. Rats were then randomly assigned to 2 groups. The rats in group A(n=42) received PEMS by placing them in custom cages equipped with Helm-holz coils(3 hr/day, 5 days/wk, for 12 wk). The rats in group B(n=42) were handled the same way as the group A, except that they did not receive PEMS. Laryngovideoendoscopy was performed before and after surgery and followed up weekly. Laryngeal EMG was obtained in both PCA and TA muscles. Immunohistochemisty staining using monoclonal anti-neuronal nitric oxide synthase(nNOS) antibody was performed to detect nNOS in recurrent laryngeal nerve and nodose ganglion. Results : 20 rats(63%) in group A and 5 rats(17%) in the group B showed recovery of vocal fo1d motion. The number of NOS-positive cells was increased in functionally-recovered rats. NOS-staining intensity was reduced 12 weeks after nerve injury. The difference between PEMS group and non-stimulated group was not found. Conclusion : This study shows that nNOS may exert a beneficial effect on nerve regeneration and functional repair.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권5호
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• pp.233-240
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• 2019

Trigeminal nerve injury as a consequence of lower third molar surgery is a notorious complication and may affect the patient in long term. Inferior alveolar nerve (IAN) and lingual nerve (LN) injury result in different degree of neurosensory deficit and also other neurological symptoms. The long term effects may include persistent sensory loss, chronic pain and depression. It is crucial to understand the pathophysiology of the nerve injury from lower third molar surgery. Surgery remains the most promising treatment in moderate-to-severe nerve injuries. There are limitations in the current treatment methods and full recovery is not commonly achievable. It is better to prevent nerve injury than to treat with unpredictable results. Coronectomy has been proved to be effective in reducing IAN injury and carries minimal long-term morbidity. New technologies, like the roles of erythropoietin and stem cell therapy, are being investigated for neuroprotection and neural regeneration. Breakthroughs in basic and translational research are required to improve the clinical outcomes of the current treatment modalities of third molar surgery-related nerve injury.

• 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.