• 제목/요약/키워드: facial

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양측성 안면신경마비 치험 1례에 관한 고찰 (Clinical Observation on 1 Case of Patient with Bilateral Facial Palsy)

  • 김민정;박상동;이아람;김경호;장준혁;김갑성
    • Journal of Acupuncture Research
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    • 제19권2호
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    • pp.238-249
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    • 2002
  • Facial palsy is commonly encountered disease in the clinic but bilateral facial palsy is known as rare disease. Type of facial nerve paralysis include unilateral, recurrent ipsilateral, recurrent alternating and bilateral simultaneous palsies. Among the types, the reported incidence of bilateral simultaneous palsy is 0.3~2% of facial paralysis patients. We experienced I case of patient with bilateral simultaneous facial palsy that was concluded as bilateral bell's palsy. Objective : The purpose of this paper is to report the patient with bilateral facial palsy, who improved by oriental medical treatment. Another purpose is to review the current literature and to differential diagnosis of bilateral facial paralysis. Methods and Results : The patient was treated by acupuncture, herb medication and self-massage on facial muscle for 14 weeks. House-brackmann grading score was improved into I/I (Rt/Lt) from IV/IV. Conclusion : Through reviewing some literatures and reports, It is concluded that bilateral facial palsy was related to many other disorders and more ominous than unilateral facial palsy. therefore, its work-up should include a complete neurologic assesment and thorough evaluation. also, we consider that bilateral Bell's palsy can improve by oriental medical treatments.

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안면신경 침범시의 수술적 처치 (Surgical Dilemma of Facial Nerve Invasion)

  • 노영수
    • 대한두경부종양학회지
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    • 제24권1호
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    • pp.9-14
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    • 2008
  • The most important concern to do parotidectomy is correct identification of the facial nerve and preservation of the nerve function. Many descriptions for the localization and branching types of the facial nerve trunk have existed. During the parotid surgery, it is necessary to have knowledges about the incidence and prognostic aspect of a invasion of the facial nerve by the parotid tumors. The method of the dissection and the surgical extent of the parotid gland would be decided not only by the anatomic variation of the facial nerve. but also the size and location of the tumor. Invasion of the facial nerve in parotid malignancies is the most significant factors affecting the prognosis, so radical parotidectomy which consists of the total extirpation of the parotid gland in conjunction with resection of the facial nerve is often required for proper management. Radical parotidectomy is advocated for the surgical treatment of high grade malignancies and in selective recurrent benign tumors intimately involving the facial nerve. Unfortunately, the morphologic and functional deficits created by sacrificing the facial nerve can be emotionally and physically traumatizing to the patient. Therefore, when the facial nerve is sacrificed, immediate reconstruction of the facial nerve should be necessary. Immediate nerve repair with direct anastomosis of the resected nerve ends or placement of a cable nerve graft provides the better cosmetic and functional results. Surgical resection remains the mainstay of treatment for cancer of the parotid gland, and there is general agreement that facial nerve should not be sacrificed unless the tumor is adherent to, or surrounds the nerve. The following statement is described general principles of troublesome management of the facial nerve during surgery for parotid tumor.

Significance of Preoperative Nerve Reconstruction Using Diffusion Tensor Imaging Tractography for Facial Nerve Protection in Vestibular Schwannoma

  • Yuanlong Zhang;Hongliang Ge;Mingxia Xu;Wenzhong Mei
    • Journal of Korean Neurosurgical Society
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    • 제66권2호
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    • pp.183-189
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    • 2023
  • Objective : The facial nerve trace on the ipsilateral side of the vestibular schwannoma was reconstructed by diffusion tensor imaging tractography to identify the adjacent relationship between the facial nerve and the tumor, and to improve the level of intraoperative facial nerve protection. Methods : The clinical data of 30 cases of unilateral vestibular schwannoma who underwent tumor resection via retrosigmoid approach were collected between January 2019 and December 2020. All cases underwent magnetic resonance imaging examination before operation. Diffusion tensor imaging and anatomical images were used to reconstruct the facial nerve track of the affected side, so as to predict the course of the nerve and its adjacent relationship with the tumor, to compare the actual trace of the facial nerve during operation, verify the degree of coincidence, and evaluate the nerve function (House-Brackmann grade) after surgery. Results : The facial nerve of 27 out of 30 cases could be displayed by diffusion tensor imaging tractography, and the tracking rate was 90% (27/30). The intraoperative locations of facial nerve shown in 25 cases were consistent with the preoperative reconstruction results. The coincidence rate was 92.6% (25/27). The facial nerves were located on the anterior middle part of the tumor in 14 cases, anterior upper part in eight cases, anterior lower part in seven cases, and superior polar in one case. Intraoperative facial nerve anatomy was preserved in 30 cases. Among the 30 patients, total resection was performed in 28 cases and subtotal resection in two cases. The facial nerve function was evaluated 2 weeks after operation, and the results showed grade I in 12 cases, grade II in 16 cases and grade III in two cases. Conclusion : Preoperative diffusion tensor imaging tractography can clearly show the trajectory and adjacent position of the facial nerve on the side of vestibular schwannoma, which is beneficial to accurately identify and effectively protect the facial nerve during the operation, and is worthy of clinical application and promotion.

안면마비 후유증 및 평가 방법에 대한 고찰 (A Study of Facial Palsy Sequelae and Evaluating Scale)

  • 이정우;권신애;김민정;송지연;김필군;서병관;우현수;박동석;백용현
    • Journal of Acupuncture Research
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    • 제28권2호
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    • pp.75-87
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    • 2011
  • Objectives : The purpose of this study is research on facial palsy sequelae and evaluating scale that have studied insufficiently until now. Methods : We researched on the symptoms, epidemiology and evaluating scale of facial palsy sequelae. For this, we searched the research papers on facial palsy sequelae and the clinical papers that find out the effect of treatment by evaluating facial palsy sequelae. Results : The symptoms of facial palsy sequelae are synkinesis, contracture, spasm, crocodile tears syndrome, tearing decrease, gustation impairment, hearing impairment, tinnitus, hyperacusis, etc. Among these, synkinesis, contracture, spasm and crocodile tears syndrome are the most frequently observed broadly. The poor prognosis factor of facial palsy can be the risk factor of facial palsy sequelae. For example, severe degeneration of facial nerve can be the risk factor of facial palsy sequelae. Most of clinical papers on facial palsy sequelae have used NRS(numeric rating scale) as evaluating scale. But NRS is very subjective scale. The scales of Stennert, Peitersen, Murata et al. can evaluate facial palsy sequelae grossly. Sunnybrook scale, Sydney scale, SAQ(synkinesis assessment questionnaire), the scale of Kim, the scale of Scott, HFS-7(hemi facial spasm), HFS-36 and Schirmer's test can evaluate the respective symptoms of facial palsy sequelae. Conclusions : The symptoms of facial palsy sequelae are synkinesis, contracture, spasm, crocodile tears syndrome, etc. Most of clinical papers on facial palsy sequelae have used NRS as evaluating scale. There were some scales that can evaluate facial palsy sequelae grossly and respectively. In future, we will need more progressed study of facial palsy sequelae and evaluating scale.

비폐쇄를 보이는 III급 부정교합아동의 기도 공간 형태와 안모 골격 형태와의 상관관계 연구 (A study on the correlation between airway space and facial morphology in Class III malocclusion children with nasal obstruction)

  • 정호림;정동화;차경석
    • 대한치과교정학회지
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    • 제37권3호
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    • pp.192-203
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    • 2007
  • 본 연구는 비폐쇄를 보이는 III급 부정교합아동에서, 기도 공간의 형태와 안모 골격 형태 사이의 상관관계를 평가하였다. III급 부정교합을 보이며, 비폐쇄 소견을 보여 이비인후과로 의뢰된 환아 100명의 초진 측모 두부 규격 방사선 사진에서 상 인두기도 공간(upper PAS), 하 인두기도 공간(lower PAS), 편도의 크기, 구개-혀 공간을 측정하여 기도 공간 형태를 분석하였으며, 통상적인 계측점을 사용하여 안면 골격 분석을 시행하여 기도 공간 형태 계측항목과 안면 골격분성 항목간의 상관관계를 연구하여 다음과 같은 결과를 얻었다. Upper PAS는 ramal height, SNA, SNB, PFH, FHR, facial plane angle 항목과 양의 상관관계를 보였으며, saddle angle, articular angle, gonial angle의 sum, SN-GoGn, Y-axis to SN, FMA 항목과 음의 상관관계를 보였다. Lower PAS는 genial angle, FMA와 양의 상관관계를 보였으며, articular angle, facial depth, PFH, FHR와 음의 상관관계를 보였다. 편도의 크기는 PCBL, ramal height, Mn. body length, Mn. body length to ACBL, facial depth, facial length, PFH, AFH와 양의 상관관계를 보였다. 구개-혀 공간은 saddle angle, articular angle, genial angle의 합, facial length, AFH, FMA, LFH와 양의 상관관계를 보였으며, IMPA, overbite와 음의 상관관계를 보였다.

LLE 알고리즘을 사용한 얼굴 모션 데이터의 투영 및 실시간 표정제어 (Realtime Facial Expression Control and Projection of Facial Motion Data using Locally Linear Embedding)

  • 김성호
    • 한국콘텐츠학회논문지
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    • 제7권2호
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    • pp.117-124
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    • 2007
  • 본 논문은 얼굴 모션 캡쳐 데이터를 재사용하여 실시간 표정 제어 및 표정 애니메이션을 생성하기 위한 방법론을 기술한다. 이 방법의 핵심요소는 얼굴 표정들을 정의할 수 있는 표정상태 표현법을 정하고, 이를 LLE 알고리즘에 적용하여 표정들을 적당한 공간에 분포시키는 방법론과, 이 공간을 사용하여 실시간 표정 애니메이션 생성 및 표정제어를 수행하기 위한 사용자 인터페이스 기법이다. 본 논문에서는 약 2400개의 얼굴 표정 프레임 데이터를 이용하여 공간을 생성하고, 애니메이터가 이 공간을 자유롭게 항해할 때, 항해경로 상에 위치한 얼굴 표정 프레임 데이터들이 연속적으로 선택되어 하나의 애니메이션이 생성되거나 표정제어가 가능하도록 하였다. 약 2400개의 얼굴 표정 프레임 데이터들을 직관적인 공간상에 분포하기 위해서는 얼굴 표정 프레임 데이터로부터 얼굴 표정상태를 표현할 필요가 있고, 이를 위해서는 임의의 두 마커 사이의 거리들로 구성된 거리행렬 벡터를 이용한다. 직관적인 공간에서의 데이터 배치는 얼굴 표정상태벡터들의 집합을 LLE 알고리즘에 적용하고, 이로부터 2차원 평면에 균일하게 분포하였다. 본 논문에서는 애니메이터로 하여금 사용자 인터페이스를 사용하여 실시간으로 표정 애니메이션을 생성하거나 표정제어를 수행하도록 하였으며, 그 결과를 평가한다.

Facial 'Phi' Mask를 사용한 골격성 부정교합 환자의 안모 분석 (Facial Analysis of Patients with Skeletal Malocclusion Using a Facial 'Phi' Mask)

  • 김홍석;허영민;홍종락;김창수;팽준영
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제34권1호
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    • pp.26-33
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    • 2012
  • Purpose: The golden ratio has been used for a long time to objectify and quantify 'beauty'. Dr. Marqurardt claims that the golden ratio can be applied in the maxillofacial field as well. The purpose of this study was to evaluate the diagnostic significance of using a facial 'phi' mask for analyzing Korean faces with characteristics of Class I, II, and III malocclusion. Methods: We studied twenty five Korean celebrities' frontal facial photos (10 males, 15 females) and 90 malocclusion patients' frontal facial photos (30 patients in each malocclusion classification: Class I, Class II, and Class III). Patients who received orthodontic treatment at Samsung Medical Center were selected for this study. After superimposition of the selected facial photo and facial 'phi' mask using Adobe Photoshop CS3, the ratio of the entire facial area, mid facial area, lower facial area and horizontal and vertical lengths were measured. Results: The facial ratio in photos of Korean faces showed larger vertical and horizontal ratios than the facial 'phi' mask with golden ratio, regardless of skeletal malocclusion (entire face: 115%, lower face: 125% larger than the mask). The results of the frontal photos of Class I, II, and III malocclusion patients using facial 'phi' mask showed that the vertical length and frontal face area was more significantly influenced by the area of the lower face than the midface. This means that the lower face has larger proportions in the facial areas. Conclusion: The ratio of facial 'phi' mask is matched with the ideal facial appearance that the contemporary Korean general public is seeking. Thus, the facial 'phi' mask may be a convenient tool for esthetic analysis of Korean faces. Reducing the area of the lower face is esthetically more desirable for almost all Korean people when planning orthognathic surgery.

안면신경마비의 발생과 사회경제적인 요인과의 관계 (A Study on the Relationship of Incidence of Facial Palsy with Socioeconomic Factors)

  • 정달림;김지훈;이승덕;홍승욱
    • Journal of Acupuncture Research
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    • 제28권1호
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    • pp.117-124
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    • 2011
  • Objectives : Bell's palsy is the most common acute facial paralysis but its causes still unclear. At present, one of the most widely accepted cause is viral infections, and generally socioeconomic factors influence the viral infections. The purpose of this study is to investigate the relationship of incidence of facial palsy with socioeconomic factors. Methods : Seventeen patients with a acute facial palsy, who volunteered and completed all of the assessment measures participated. Using data on 17 participants, we examined the independent contribution of education, income, and occupation to a risk factor of severe facial palsy. Severity of global facial impairment was assessed by the facial disability index (FDI), the house-brackmann facial nerve grading system, WHO quality of life - bref (WHOQOL-BREF) and visual analogue scale (VAS) about discomfort of life. Results : There was no correlation between severity of facial palsy and gender, marriage, education, or occupation. Age greater than 60 years (p<0.05), and low monthly income(p<0.05), poor self-rated health was associated with greater severity of idiopathic facial paralysis. Conclusions : The number of subjects with facial palsy in our study (n-17) was small, and therefore generalization to larger patient populations might be unwarranted. But according to the outcome, we suggest that socioeconomic factors, especially low monthly income influence severity of bell's palsy.

경혈탐측기를 이용한 말초성 안면신경마비환자의 족부반사구 변화에 대한 임상적 고찰 (The Clinical Study on Measurement of Foot Reflex Zone Acupoint Detection of Facial Paralysis Patients by Acupoints Detector)

  • 왕개하;이은솔;황지후;김유종;김경호;김승현;윤인애;조현석
    • Journal of Acupuncture Research
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    • 제29권1호
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    • pp.1-8
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    • 2012
  • Objectives : We investigate the characteristics of foot reflex zone acupoint of facial paralysis patients. Methods : In order to make a comparison between facial nerve paralysis patient group and non-facial paralysis group, we measured foot reflex zone acupoint detection in both group of 18 patients who were diagnosticated to facial nerve paralysis and 18 persons who were not. Results : 1. In comparing the means of the foot reflex zone, the measurements of facial nerve paralysis group is different significantly from non-facial paralysis group(p<0.05). 2. The measurement of detection of foot reflex zone acupoints, such as hypophysis(垂體), nose(鼻), cerebrum(大腦), neck(頸項), Trapezius muscle(僧帽筋), eye(眼) and ear(耳) of the facial nerve paralysis group is different significantly in comparison with non-facial paralysis group(p<0.05). But the measurement of detection of foot reflex zone acupoints, such as trigeminal nerve(三叉神經), cerebellum (小腦), kidney(腎), ureter(輸尿管) and urinary bladder(膀胱) of the facial nerve paralysis group is not defferent significantly in comparison with non-facial paralysis group(p>0.05). Conclusions : The results suggest that foot reflex zone can be used in the diagnosis and treatment of facial nerve paralysis.

후방접근 안면신경탐색 이하선 절제술과 수술후 안면신경 기능 (Risk of Facial Palsy after Parotidectomy Using Posterior Approach to the Facial Nerve)

  • 정웅윤;정준;박정수
    • 대한두경부종양학회지
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    • 제12권2호
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    • pp.193-200
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    • 1996
  • We performed a retrospective study to evaluate the effect of posterior approach to facial nerve in parotid surgery, being the standard procedure in our hospital, on postoperative facial palsy and to access the safety of this procedure in preserving the function of facial nerve. A series of 176 parotid surgeries from 172 patients from January 1989 to December 1994 was analyzed, of which, 2 Schwannomas, 4 Kimura's diseases, 6 preoperative facial palsies, and 4 intentional nerve resections for malignancy were excluded. Factors such as pathology of tumor, extent of surgery, location of tumor, size of tumor, frequency of surgery were reviewed to determine if any factor contributed to the developement of facial palsy postoperatively. Of 160 parotidectomies, postoperative facial palsy was found in 58(36.3%), being temporary in 35(35. 6%), recovered within 12 months after surgery and permanent in 1(0.6%). Facial palsy occured in 47(35.7%) of 128 benign tumors, 42(89.5%) recovered completely within 6 months and in 11(34.4%) of 32 malignant tumors, 6(54.5%) within 6 months. Among the factors analyzed, postoperative facial palsy was found to be common in the tumors of deep lobe(p<0.02) and in total or neartotal parotidectomies(p<0.08). In our study, the factors of the location of tumor and extent of surgery would be contributable to developement of postoperative facial palsy and the surgical technique using posterior approach to the facial nerve may be a simple and safe surgical procedure for identification and preservation of facial nerve in parotid surgery.

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