• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권3호
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• pp.276-280
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• 2011

BSSRO (bilateral sagittal split ramus osteotomy) is an effective surgical method for maxillofacial deformities. Rigid fixation using a plate and screws can stabilize bony segments and induce early mouth opening. Though this procedure has a low complication rate, normal function and esthetic recovery is achieved through proper and early management of the complications. Complications consisting of temporomandibular disorders, sensory disturbances due to inferior alveolar nerve damage, open bite, malunion or nonunion, and facial nerve palsy occur, but these rarely develop. Facial nerve palsy causes the muscles involved in facial expression to depress, which results in ocular dryness or retinal damage. When facial nerve palsy develops, early management involving steroid medication and physical therapy is effective. In the case of severe damage, surgical intervention should be considered. A 20-year-male patient came to the oral and maxillofacial surgery department for orthognathic surgery. The mandible was set back by BSSRO under general anesthesia. Facial nerve palsy was observed on the left side of the face: steroid and vitamins were administered early and physical therapy was performed daily. These forms of management can aid in function and allow for gradual esthetic recovery. Presumed causes were excessive soft tissue retraction or soft tissue injury by the osteotome at the horizontal osteotomy of the ramus. Careful dissection, retraction and a precise osteotomy are needed for protection of the facial nerve. If nerve damage is observed, early management can help in the recovery of facial nerve function and esthetics.

• Journal of Acupuncture Research
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• 제29권6호
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• pp.23-34
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• 2012

Objectives : This study was performed to define clinical character of peripheral facial nerve injury. Methods : 36 patients was identified with peripheral facial nerve injury among 1128 patients who visited the Facial Palsy Center in Kyung Hee University Hospital at Gang-dong between January 2010 and November 2011. We reviewed the medical records including gender, age, cause, symptom, period of treatment, and axonal loss. Results : Most common cause of peripheral facial nerve injury was iatrogenic surgery, followed by direct trauma, neoplastic disorders. Patients with facial nerve injury commonly complain about facial palsy(ipsilateal or bilateral), followed by paresthesia, facial spasm, facial pain, auricular pain. Peripheral facial nerve injury group showed worse electrophysiological pattern and younger onset age compared with Bell's palsy group. Conclusion : This study was designed for 36 patients and further studies are necessary.

• 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.

• The Korean Journal of Pain
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• 제11권2호
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• pp.326-331
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• 1998

Facial nerve paralysis is a common pain clinical diagnosis. But ipsilateral or contralateral recurrent facial paralysis is found in about 2.6~19.5% of facial paralysis and especially bilateral facial paralysis is rare. While idiopathic facial paralysis is the most common diagnosis, a comprehensive evaluation must be completed prior to this diagnosis in patients with bilateral facial paralysis. A representative case of bilateral alternating facial paralysis treated with stellate ganglion block (SGB) is presented. A 57 years old male patient who had the onset of a right facial paralysis 7 months ago visited pain clinic. Five months after the onset of right facial paralysis, as it was improving, he developed a left facial paralysis. He had history of hypertension, diabetus mellitus and pain episode on mastoid process before facial paralysis developed. Electrical test showed incomplete neuropathy on both side and computed tomography (CT) scan was normal. He was treated with SGB, physical theraphy and aspirin medication. After 25 times SGB, he was recovered almost completely.

• 대한한방내과학회지
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• 제43권5호
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• pp.989-996
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• 2022

The purpose of this study is to report a rare case of bilateral facial palsy after endoscopy and the effects of a series of traditional Korean medicine treatments applied to the patient. The patient was treated with Western oral medications for seven days and then with traditional Korean medicine consisting of acupuncture, moxa, and herbal medicine (Dodamgeopung-san-gami and Yukgungeopung-san-gami) for two months. Treatment progress was measured using the House-Brackmann grading system and Yanagihara's unweighted grading scale. We were able to notice some improvements in the patient's symptoms: the House-Brackmann scale went from 5/4 to 2/1, and the Yanagihara scale from 13/16 to 38/40. This study thus reports that traditional Korean medicine treatments can be applied to bilateral facial palsy found in rare cases and still be effective.

• Journal of Acupuncture Research
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• 제27권6호
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• pp.95-100
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• 2010

Objectives : The aim of this study was to investigate the characteristics of Ryodoraku and association of Ryodoraku in Idiopathic Facial Paralysis Patients Methods : Subjects were 53 patients with Facial palsy patients and 28 normal people. We calculated the average Ryodoraku score(RS, ${\mu}A$) and each variation from physiologic range of 12 Ryodoraku points, and investigated the incidence when left and right points were simultaneously below(bilateral deficiency) or above(bilateral excess) physiologic range. Results : The electric current value of several meridian of normal group was more higher in idiopathic facial palsy group than in normal group. The measurement value of Ryodoraku followed sex was not significant statistically. Conclusions : These findings suggest that the measurement value of several Meridians of Ryodoraku is more higher in idiopathic facial palsy group than in normal group, because Ryodoraku has low correlation with Parasympathetic nerve.

• Annals of Clinical Neurophysiology
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• 제6권1호
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• pp.26-30
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• 2004

Background: Electrophysiologic study accurately predicts the degree of degenerated motor axons but cannot give precise information on the type of injury that occurred in Bell's palsy. Because of these limitation for prognostic prediction in Bell's palsy, we evaluated divergence of electrophysiological time course for the purpose of presuming the type of injury in Bell's palsy. Methods: We did bilateral facial nerve conduction studies in 103 Bell's palsy patients, who visited to Han-Gang sacred heart hospital from 1998 to 2001. We compared the CMAP amplitude of disease site with that of normal site and suggested that decremental CMAP amplitude ratio (percentage) as a degree of denervation of affected facial nerve. Then we demonstrated the time course of denervation percentage. After defining normal range of CMAP amplitude difference from normal control group, we also evaluated if distinct time course of early minimal denervation is present. Results: Our results show that time course of the denervation in early stage of Bell's palsy reflect various injury type such as axonotmesis, neurotmesis or other unidentified type. We cannot identify the distinct time course of early minimal denervation. Conclusions: The time course as well as the maximal value of denervation are the best prognostic guidelines in Bell' s palsy. So repeated serial electrophysiologic test are inevitable to assess prognosis. As an another topic, early minimal denervation for prognostic prediction deserve to be evaluated as a future work up for prognostic prediction.

• Annals of Clinical Neurophysiology
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• 제7권2호
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• pp.117-120
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• 2005

Hemifacial spasm (HFS) may develop after Bell's palsy (BP). But it was not reported that contralateral HFS occurred simultaneously in acute BP. A 25-year-old woman admitted with left HFS occurred simultaneously in acute right BP for 6 days. Past, family, and social history were unremarkable. Nerve conduction studies (NCS) and blink reflex (BR) test showed bilateral facial neuropathies. Brain MRI and cerebral angiography were normal. The symptoms and signs of HFS and BP were improved slowly after acyclovir and prednisolone therapy. Follow-up serial NCS and BR also showed a rapid improvement.

• 한방안이비인후피부과학회지
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• 제33권4호
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• pp.133-144
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• 2020

Objectives : The purpose of this study is to report the effect of Korean medicine treatment on limitation of eye movement in Miller-Fisher Syndrome. Methods : A patient was treated with herbal medicines, acupuncture(including electropuncture, phamacopuncture), Moxibustion and cupping therapy. To evaluate the result of this treatment, we used photographs of eye movement, Scott and Kraft score of both eye, length of eyeball movement and visual analogue scale(VAS) for subjective symptoms. Results : After treatment, the limitation of eye movement and diplopia were remarkably improved. Also, other symptoms such as dizziness, gait disturbance, facial nerve disorder were disappeared. Conclusions : This study suggests that Korean medicine treatments are effective for patient with limitation of eye movement in Miller-Fisher Syndrome.

• Advances in pediatric surgery
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• 제2권2호
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• pp.119-128
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• 1996

The survey on branchial anomalies was conducted by Korean Association of Pediatric Surgeons. A total of 173 cases were reported, which were managed by 36 members and cooperators during the three years from January 1, 1993 through December 31, 1995. The following results were obtained by retrospective analysis of the 173 cases of branchial anomalies. The presenting symptoms were cervical mass in 101 cases, pit with or without discharge in 71, cervical abscess in 47 and respiratory difficulty in 3. The average age of the patients with cervical abscess was 52 months. Seventy(79%) of 89 patients with branchial anomalies and a cystic mass had their first clinical manifestations by 1 year of age, while 40(51%) of 78 patients with only a branchial cyst had their first clinical manifestation in first year of life. Radiologic studies were carried out in 77 patients (43%). The preferred diagnostic modalities were ultrasonography(47 patients), simple neck radiogram(19) and CT scan(17). Preoperative diagnosis was correctly made in 156(91%) of 173 patients. Seventeen patients were incorrectly diagnosed as thyroglossal duct cyst in 5 patients, cystic hygroma in 4, dermoid cyst in 3, and lymphadenopathy in 3. There were no remarkable difference in sex and laterality of presentation but bilateral lesions were found in 9(5%) patients and unusual locations of the anomalies were the manubrium, left subclavicular area, median cervial area, preauricular and parotid area. There were 78(45%) patients with cyst, 52(30%) patients with sinus, 35(20%) patients with fistula and 8(5%) patient with skin tag. Embryological classification was possible in only 64(37%) patients. The 2nd branchial anomaly was present in 50(78%), the 1st branchial anomaly in 10(18%), and the 3rd or 4th branchial anomaly in 4(6%). Histopathological study of the lining epithelium(N=134) is recorded that 45% were lined with squamous epithelium, 17% with respiratory epithelium, 6% with. squamous and respiratory epithelium, 14% with inflammatory change. Lymphoid tissue was common(62%) in the wall of the lesions. Twelve(7%) of 158 patients had postoperative complications including wound complication, recurrence and facial nerve palsy.