• 한방안이비인후피부과학회지
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• 제23권2호
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• pp.196-205
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• 2010

Objective : This study was designed to evaluate the effect of Miso Facial Acupuncture on Orbicularis Oculi muscle. Methods : Two men and four women with Facial nerve palsy were recruited. Miso Facial Acupuncture on Orbicularis Oculi muscle was performed two times a week for three weeks. The effects of the treatment were evaluated by H-B scale, Y-system and clinical symptom. Results : Before treatment with Miso Facial Acupuncture, three patients showed H-B scale improvement and the other three patients had no change. and four patients showed Y-system improvement and the other two patients had no change. In six cases, the patients had improvement in clinical symptom related with Orbicularis Oculi muscle function. Conclusion : Miso Facial Acupuncture on Orbicularis Oculi muscle showed significant improvement in facial nerve palsy.

• Archives of Plastic Surgery
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• 제45권2호
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• pp.135-139
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• 2018

Background Static reconstruction surgery that tightens the tension of the inferior tarsus, thereby raising the lax lower eyelid, is a common treatment for paralytic ectropion of the lower eyelid. We present one such operative procedure, in which an orbicularis oculi muscle flap was used. Methods The surgical technique involves partial resection of the tarsus and the skin, as well as a superior-based orbicularis oculi muscle flap that is sutured to the firm tissue present on the Whitnall tubercle. The muscle flap is approximately 7 mm in width and 15 mm in length, with a superior pedicle that is attached to the tarsus at the medial point of the resected tarsus. The procedure results in contact between the ocular surface and the lower eyelid. Results The procedure was performed in 11 patients with lower eyelid ectropion due to facial paralysis. Ten cases showed a favorable outcome following surgery, with stable results seen over an average follow-up period of 4.5 years. In one case, recurrence of ectropion was observed 2 months after surgery due to an insufficient correction, and the patient required repeat surgery. Conclusions The orbicularis oculi muscle flap was an effective means of suspension and was able to maintain long-term traction tension. This procedure can therefore be considered a favorable treatment option for lower eyelid ectropion due to facial paralysis.

• Korean Journal of Acupuncture
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• 제25권2호
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• pp.1-32
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• 2008

Objectives : This study was performed to understand the interrelation between 'Foot three yang meridian-muscle' and 'muscular system'. Methods : We have researched some of the literatures on Meridian-muscle theory, anatomical muscular system, myofascial pain syndrome and anatomy trains. And especially we have compared myofascial pain syndrome to anatomy trains and researched what kind of relationship is exist between them. Results : It is considered that Foot taeyang meridian-muscle includes Abductor digiti minimi m., Gastrocnemius m., Biceps femoris m., Longissimus m., Omohyoid m., Occipital m., Frontal m., Orbicularis oculi m., Trapezius m., Sternocleidomastoid m., Sternohyoid m., Zygomaticus m. Foot soyang meridian-muscle includes Dorsal interosseus m., Tendon of extensor digitorum longus m., Extensor digitorum longus m., Iliotibial band, Vastus lateralis m., Piriformis m., Tensor fasciae latae m., Internal abdominal oblique m., External abdominal oblique m,, Internal intercostal m., External intercostal m., Pectoralis major m., Sternocleidomastoid m., Posterior auricular m., Temporal m., Masseter m., Orbicularis oculi m. Foot yangmyung meridian-muscle includes Extensor digitorum longus m., Vastus lateralis m., Iliotibial band, Iliopsoas m., Anterior tibial m., Rectus femoris m., Sartorius m., Rectus abdominis m., Pectoralis major m., Internal intercostal m., External intercostal m., Sternocleidomastoid m., Masseter m., Levator labii superioris m., Zygomatic major m., Zygomatic minor m., Orbicularis oculi m., Buccinator m. and the symptoms of Foot three yang meridian-muscle are similar to the myofascial pain syndrome. Superficial back line in anatomy trains is similar to the pathway of Foot taeyang meridian-muscle. Lateral Line in anatomy trains is similar to the pathway of Foot soyang meridian-muscle. Superficial Front Arm Line in anatomy trains is similar to the pathway of Foot yangmyung meridian-muscle. Conclusions : There is some difference between myofascial pain syndrome and meridian-muscle theory in that the former explains each muscle individually, while the latter classifies muscular system in the view of integrated organism. More studies are needed in anatomy and physiology to support the integration of muscular system of Foot three yang meridian-muscle in aspect of anatomy trains.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.603-609
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• 2013

Background Although the conventional direct brow lift operation provides a simple means of managing lateral brow ptosis, the scars produced have been unacceptable. However, using the modifications proposed here, scarring showed remarkable improvement. This article reviews our experiences with the presented technique, mainly with respect to postoperative scarring. Methods Measured amounts of supra-eyebrow skin and subcutaneous fat were excised en bloc in the conventional manner under 'hyper-hydrated' local infiltration anesthesia. The lower flap and the edge of the upper flap were undermined above the muscular plane, and the orbicularis oculi muscle was directly suture-plicated and suspended upward to the distal frontalis muscle. Skin closure was performed in a basic plastic surgical manner. Results From April 2007 to April 2012, a consecutive series of 60 patients underwent surgery using the above method. The average width of the excised skin was 8 mm (range, 5-15 mm) at the apex of the eyebrow. Preoperative complaints were resolved without occurrence of significant complications. The surgical scars showed remarkable improvement and were negligible in the majority of the cases. Conclusions The direct brow lift operation combined with plication/suspension of the superior and lateral portion of the orbicularis oculi muscle provides a simple, safe, and predictable means of correcting lateral brow ptosis. The scars were acceptable to all of the patients. For proper management of the frontalis tone, upper blepharoplasty and/or repair of eyelid levator function must be considered in addition to brow lift procedures.

• Archives of Plastic Surgery
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• 제32권3호
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• pp.397-402
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• 2005

For its lowerlid entropion correction, nonsurgical eyelid suture or surgical eyelid suture can be employed. Different types of surgical eyelid suture such as the Hotz method and the Callahan method, are generally performed, but were not sufficient for correcting of entropion. In our hospital we performed modified skin-tarsal fixation on 15 patients, 5 male and 10 female from January 20, 1999 to December 16, 2002. We corrected lower eyelid entropion with the excision of the skin and orbicularis oculi muscle and buried suture of tarsal plate and dermis which is a variant of the Callahan method. All the patients were satisfied with the operation results, and there was no case of recurrence of the lower eyelid pricking the cornea. During the 6 months period after the operation, the lower eyelids slightly turned inward but there was no further progression. The correction was performed excessively, therefore there was no case of recurrence after the operation and the results were satisfactory. There developed a dimple at the suture margin caused by skin contraction but it usually disappeared within 2 months after the operation. To avoid recurrence and to achieve satisfactory results, the orbicularis oculi muscle must be totally resected at the ciliary margin. We resected ciliary as well as pretarsal portion of orbicularis oculi muscle. Also, since most of the recurrences are originated from the medial side, the medial portion of skin flap must be tightly fixed to avoid recurrence and the upper part of the dermis should be fixed tightly to the lower border of the tarsal plate.

• Archives of Plastic Surgery
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• 제36권2호
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• pp.194-199
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• 2009

Purpose: The orbital fat buldging may cause irregular contour of lower eyelid, which is not youthful appearance. The conventional method of fat excision may cause the eyeball to move backward and downward, making enopthalmia is inevitable. The transcutaneous approach to reach the orbital septum can increase the risks of scleral show resulting from scarification at the level of the septum orbicularis junction and damaging the vertical motor branches of the preseptal orbicularis oculi muscle of the lower eyelid. Method: From July 2007 to March 2008, total of 21 patients underwent transconjunctival capsulopapebral fascia fixation procedure. In 8 patients, the herniated fat pad of the lower eyelid was relocated back into the orbit without external skin excision using capsulopalpebral fascia fixation. But in 13 patients, excision of redundant skin of the lower eyelid was performed using pinching technique, not involving orbicularis oculi muslce. In 5 patients, lateral canthotomy was done bilaterally for good visual field. In 6 patients, lateral canthopexy was also combined to correct loosening of lower eyelid. Results: Most of the patients were satisfied after at least 5 months of follow up. No patient showed scleral show. But 2 patients complained of undercorrection slightly, without secondary operation in 1 patient and re - capsulopalpebral fascia fixtation through transconjunctival approach in another patient. Conclusion: Orbital fat repositioning using transconjunctival capsulopalpebral fascia fixation is a good procedure to show youthful appearance without increasing the risk of scleral show and also showed fast recovery compared to the conventional transcutaneous approach.

• Journal of Acupuncture Research
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• 제32권4호
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• pp.69-76
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• 2015

Objectives : The aim of this study was to observe the effect of Embedding therapy on complete facial palsy after primary treatment. Methods : 11 patients with complete facial palsy were treated with Embedding therapy. It was performed once a day, every two weeks. 15~20 Embedding threads were used in each Embedding therapy treatment. The total number of Embedding therapy treatments was 4 or 8. Frontalis muscles (including the Yangbaek ($GB_{14}$)), Orbicularis oculi muscle, Levator labii superioris muscle, Zygomatic major muscle, Zygomatic minor muscle (including the Georyo ($ST_3$) and Jichang ($ST_4$)), Masseter muscle, Buccinator muscle (including the Hyeopgeo ($ST_6$)) and Orbicularis Oris muscle were selected. Yanagihara's score and House-Brackmann scale were compared for before and after treatment to evaluate the effect of Embedding therapy. Results : Yanagihara's score increased significantly (p=0.003). House-Brackmann Scale decreased significantly (p=0.005). Three patients were extremely satisfied, six patients were satisfied, and two patients responded neutrally in regards to Embedding therapy. Conclusions : Embedding therapy can be effective in improving symptoms of complete facial palsy.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.486-491
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• 2013

In performing upper blepharoplasty in the elderly, looking younger and keeping the eyelids harmonious with the rest of the face have to be achieved at the same time. The most important goal in upper blepharoplasty for aging is correcting the drooping upper eyelid skin, and in this process, the surgeon may or may not create a double eyelid fold. The pros and cons have to be fully discussed with the patient, but the author personally prefers creating a double fold unless the patient refuses, because it is efficient in correcting and preventing further drooping of the skin. In most patients, the brow is elevated to compensate for the drooping eyelid, and when the drooping is corrected, brow ptosis may ensue. The surgeon has to prepare for these consequences before performing the procedure, and estimate the exact amount of skin to be excised. In the elderly, the skin and the orbicularis oculi muscle is thin, with a decreased amount of subcutaneous fat and retro-orbicularis oculi fat, and in most cases, excision of the skin alone is enough to correct the deformity. Removing large portions of soft tissue may also prolong the recovery period. Unlike younger patients, the lower skin flap should not be stretched too much in the elderly, as it may create an aggressive looking appearance. A few wrinkles in the lower flap should remain untouched to create a natural look. In this article, the author's own methods of performing an aging blepharoplasty are described specifically, with a step-by-step guide and surgical tips.

• Annals of Clinical Neurophysiology
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• 제6권2호
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• pp.75-79
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• 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.

• 한국전문물리치료학회지
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• 제9권3호
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• pp.101-111
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• 2002

The purpose of this study was to determine EMG biofeedback training effect on the muscle activities in 3 unilateral facial palsy patients along with multiple baseline design across subjects. The auditory feedback about facial muscles (orbicularis oris, orbicularis oculi, frontalis) was provided with each patient during facial exercise training. Electromyographic (EMG) activity during maximal voluntary contraction and maximal compound muscle action potential (CMAP) amplitude elected by supramaximal electrical stimulation on facial nerve of facial muscles were measured pre- and post- EMG biofeedback training to evaluate motor learning. EMG activity during maximal voluntary contraction was increased after EMG biofeedback training and CMAP amplitude elected by supramaximal electrical stimulation was not changed in all subjects. The results indicate that EMG biofeedback training is useful method to improve motor learning of facial excercise training in unilateral facial palsy patients.