• Title/Summary/Keyword: facial pain

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TRAUMATIC TMJ INJURY (외상성 악관절 손상)

  • Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.2
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    • pp.191-199
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    • 1997
  • Mandibular trauma is developed due to traffic accident, fall down, industrial injury, and others. TMJ disorder is usually also developed after facial traumatic injury. Many authors suggested that disc displacement or tearing, acute synovitis, TMJ ankylosis, traumatic arthritis, or effusion are developed after facial trauma. It is still very controversible what is the best treatment of TMJ injury such as condylar fracture and meniscal injury. In TMJ injury, synovial inflammation is developed and pain mediators such as prostaglandin E2 or leukotriene B4 are released from the synovial membrane. This can be a cause of TMJ disorder. I present a variety of experimental study about the condylar fracture and meniscal injury and enzyme-immunoassay of synovial fluid after mandibular trauma that have been studied since 1992 and establish the treatment criteria of traumatic TMJ injury. I think that the treatment option of condylar fracture depends upon the surgeon's criteria exclusively. There are no significant differences between conservative and surgical treatment. If the aggressive functional physical therapy and long-term followup be performed, the favorable functional recovery of TMJ can be obtained. And I think that the initial surgical management of meniscus of TMJ is unnecessary in condylar fracture. And also arthrocentesis can be available to release the patient's subjective symptoms and improve the healing of injured TMJ.

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Frey Syndrome after Retromandibular Approach for Condyle Fracture Reduction (하악과두골절 수술 후 발생한 Frey Syndrome)

  • Lee, Jae-Min;Ki, Eun-Jung;Cheon, Hae-Myung;Choi, Moon-Gi
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.6
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    • pp.376-380
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    • 2013
  • Frey syndrome is a disease characterized by abnormal sweating, facial redness, and rare pain by stimulation of taste sense on the limited area dominated by the auriculotemporal nerve and great auricular nerve. Although the developmental mechanism and histopathologic cause of Frey syndrome are still being debated, the most reliable theory is based on injury of the parathympathetic nerve connected to the auriculotemporal nerve continuing to abnormal regeneration. The other theory is that the sweat glands develop an increased sensitivity after degeneration of sympathetic fibers. Therapy of Frey syndrome includes drugs, radiographic treatment, and surgical treatment; however, in most cases, treatment is not satisfactory. This is a case report on a 24-year-old male patient with Frey syndrome caused by the fracture reduction with retromandibular approach after multiple facial traumas and spontaneous healing without any special treatment.

Ruptured Total Intrameatal Anterior Inferior Cerebellar Artery Aneurysm

  • Kim, Hyung Cheol;Chang, In Bok;Lee, Ho Kook;Song, Joon Ho
    • Journal of Korean Neurosurgical Society
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    • v.58 no.2
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    • pp.141-143
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    • 2015
  • Among the distal anterior inferior cerebellar artery (AICA) aneurysms, a unique aneurysm at the meatal loop inside the internal auditory meatus is extremely rare. The authors report a case of surgically treated total intrameatal AICA aneurysm. A 62-year-old female patient presenting with sudden bursting headache and neck pain was transferred to our department. Computed tomography and digital subtraction angiography showed subarachnoid hemorrhage at the basal, prepontine cistern and an aneurysm of the distal anterior inferior cerebellar artery inside the internal auditory meatus. Surgery was performed by retrosigmoid craniotomy with unroofing of the internal auditory meatus. The aneurysm was identified between the seventh and eighth cranial nerve in the meatus and was removed from the canal and clipped with a small straight Sugita clip. After operation the patient experienced transient facial paresis and tinnitus but improved during follow up.

A Case of Varicella-Zoster virus infection with multiple cranial nerve involvement (다발성 하부뇌신경을 침범한 대상포진 감염 치험 1례)

  • Shin, Jung-Eun;Yoo, Seung-Joo;Kim, Sang-Yoon;Nam, Soon-Yuhl
    • Korean Journal of Bronchoesophagology
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    • v.5 no.2
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    • pp.222-230
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    • 1999
  • Varicella-zoster virus(VZV) becomes latent in the sensory ganglia after primary infection and emerges from latency to cause zoster in adults. After primary infection, VZV remains latent in the dorsal spinal ganglia. The mechanisms responsible for its reactivation and the clinical entity of herpes zoster are poorly understood. Reactivation of VZV is commonly known to manifest as Ramsay Hunt syndrome which is one of the VZV-associated neurologic diseases with facial paralysis, ear pain, and a characteristic herpetic auricular rash. It is now known that lesions of this syndrome can affect all cranial nerves. Central, cervical and peripheral effects of this syndrome is polyneuropathic in nature. VZV usually involves the 5th and 7th cranial nerves and less commonly the lower cranial nerves such as 9th and 10th. We report a treated case of healthy 40 years old male with VZV infection of the 5th, 9th and 10th cranial nerves. The patient typically showed herpetic vesicles in the auricle and temporal bone area without facial paralysis.

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Sensory recovery after infraorbital nerve avulsion injury

  • Lee, Sam Yong;Kim, Seung Hyun;Hwang, Jae Ha;Kim, Kwang Seog
    • Archives of Craniofacial Surgery
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    • v.21 no.4
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    • pp.244-248
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    • 2020
  • The infraorbital nerve is a branch of the trigeminal nerve. Injury to the infraorbital nerve can be caused by trauma, including various facial fractures. Due to this nerve injury, patients complain of numbness and pain in the entire cheek, the ala of nose, and upper lip. In general, spontaneous sensory recovery is expected after decompressive surgery. If nerve transection is confirmed, however, neurorrhaphy is typically performed. Here, we present a case in which microsurgery was not performed in a patient with Sunderland grade V avulsion injury of the infraorbital nerve due to a facial bone fracture. Gradual nerve function recovery was confirmed to be possible with conservative treatment and rehabilitation alone. These findings suggest that the nerve function recovery can be expected with conservative treatment, even for severe nerve injury for which microsurgery cannot be considered.

Botulinum Toxin : Basic Science and Clincal Uses in Otolaryngology (Botulinum Toxin : 기초과학과 이비인후과 영역에서의 임상적 사용)

  • 최홍식;문인석;김한수;김현직
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.13 no.2
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    • pp.164-172
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    • 2002
  • The role of botulinum toxin as a therapeutic agent is expanding rapidly in otolaryngology. Botulinum toxin is a protease that blocks the release of acetylcholine from nerve terminals. Its effects are transient and nondestructive, and largely limited to the area in which it is administered These effects are also graded according to the dose, allowing for individualized treatment of patients and disorders. Botulinum toxin has been used primarily to treat disorders of excessive or inappropriate muscle contraction. In the field of otolaryngology, these include spasmodic dysphonia, oromandibular dystonia, and blepharospasm, vocal tics and stuttering, cricopharyngeal achalasia, various tremors and tics, hemifacial spasm, temporomandibular joint disorders and a number of cosmetic applications. Botulinum toxin treatment has recently begun to show some benefit in the control of pain from migraine and tension headache. It may also prove useful in the control of autonomic dysfunction, as in Frey syndrome, sialorrhea, and rhinorrhea. In over 20 yews of use in humans, botulinum toxin has accumulated a considerable safety record, and in many cases represents relief for thousands of patients unaided by other therapy.

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The result of endoscope-assisted open reduction and internal fixation (EAORIF) of lateral overridden subcondyle fracture (Lateral override 과두하골절에서 내시경을 이용한 관혈적 정복술 및 내고정의 결과)

  • Choi, Eun-Joo;Cha, In-Ho;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.1
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    • pp.62-66
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    • 2011
  • Introduction: Endoscope-assisted open reduction and internal fixation (EAORIF) reduces the amount of facial scaring, but limitations, such as the possibility to convert to the open technique and the large learning curve, remain. Materials and Methods: The medical records of 19 patients diagnosed as lateral overridden subcondyle fractures and treated with endoscope-assisted open reduction and internal fixation at Yonsei University Health System from December 2006 to August 2010 were reviewed. Results: 11 patients underwent temporary discomfort or pain such as limitation of mouth opening, temporomandibular joint discomfort, lip paresthesia or facial weakness, but the symptoms disappeared within 3 months. There was no severe long-term complication except 2 patients with re-fractures of operated subcondyles. Conclusion: Subcondyle fracture with lateral overridden proximal segment is a better indication of endoscope-assisted open reduction and internal fixation than a condylar head/neck fracture, or medial overridden subcondyle fracture: allowing an anatomic reduction.

Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

  • Choi, Kang-Young;Yang, Jung-Dug;Chung, Ho-Yun;Cho, Byung-Chae
    • Archives of Plastic Surgery
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    • v.39 no.4
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    • pp.291-300
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    • 2012
  • The incidence of condylar fractures is high,but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture.

Safe and Effective Reduction Malarplasty (안전하고 효과적인 광대축소술)

  • Kang, Young Ho
    • The Journal of the Korean dental association
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    • v.58 no.2
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    • pp.103-113
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    • 2020
  • Background: Reduction malarplasty is one of the most popular facial contouring surgeries in east Asia for making patients' faces smaller. Currently in Korea, reduction malarplasty surgeries are performed mostly at plastic surgery clinics, but few cases are done at oral and maxillofacial surgery clinics. The reason might be because of post-operative complications after reduction malarplasty, such as undercorrection, overcorrection, asymmetry, cheek drooping, malunion, pain and noise. Those complications should be uneasy to be handled by oral and maxillofacial surgeons, however, they can be prevented by knowing the effective and safe reduction malarplasty techniques. Therefore, in this article the author as an oral and maxillofacial surgeon, would like to suggest safe and effective surgical methods for reduction malarplasty customized for Korean patients. Method: L- shape osteotomy of zygomatic body was performed with intraoral approach via vestibular incision, and the zygomatic arch was osteotomized with extraoral approach via sideburn incision. Then zygomatic complex was separated and rotated mesio-superiorly without removal of a bony strip and fixed with miniplates and microplates without making a bony gap. Conclusion: Surgical results were favorable and satisfied by the patients without cheek drooping, malunion, undercorrection and asymmetry.

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A CASE REPORT OF RHINOCEREBRAL MUCORMYCOSIS ASSOCIATED WITH UNCONTROLLED DIABETES MELLITUS (당뇨병과 연관된 비대뇌형 모균증의 증례)

  • Choi, Sung-Weon;Yun, Dong-Hee;Kim, Jung-Su;Kang, Bo-Won;Kim, Sung-Moon;Lim, Jae-Suk;Kwon, Jong-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.2
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    • pp.152-156
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    • 1994
  • Rhinocerebral mucormycosis is an acute fulminant opportunistic fungal infection in debilitated patients with underlying pathologic conditions, which are diabetic ketoacidosis, immunosuppressed disease. We experienced a case of rhinocerebral mucormycosis. The patient was 41 year-old female, who had diabetes for five years and suffered from left facial swelling and pain, left ophthalmoplegia and facial skin necrosis. Total maxillectomy was done combined with systemic Amphotericin B therapy, Biopsy proved mucormycosis but she expired.

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