• Title/Summary/Keyword: facial palsy grading system

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Comparison between Subjective Scoring and Computer-Based Asymmetry Assessment in Facial Nerve Palsy

  • Lee, Doh Young;Kim, Hyun Seok;Kim, So Young;Park, Kwang Suk;Kim, Young Ho
    • Korean Journal of Audiology
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    • v.23 no.1
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    • pp.53-58
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    • 2019
  • Background and Objectives: The aim of the present study was to assess the feasibility of a PC-based facial asymmetry assessment program (PC-FAAP) and to compare the results of PC-FAAP with subjective regional scoring by raters in acute unilateral peripheral facial nerve paralysis (FNP). Subjects and Methods: Participants were divided into 3 groups with 8 participants per group: group I, normal; group II, mild to moderate FNP; and group III, severe FNP. Using the PC-FAAP, the mouth asymmetry ratio (MAR), eyebrow asymmetry ratio (EAR), and complete eye closure asymmetry ratio (CAR) were calculated by comparing the movement of tracking points on both sides. The FNP grading scale (FGS) integrated each score, and the scores were weighted with a ratio of 5:3:2 (MAR:CAR:EAR). Subjective regional scoring was measured on a 0-100 scale score by three otologists. PC-FAAP and subjective scoring were compared in each group regarding the consistency of the results. Results: The mean scores of the MAR, EAR, CAR, and FGS of each group were significantly different. PC-FAAP showed significant differences between the three groups in terms of MAR, EAC, CAR, and FGS. PC-FAAP showed more consistent results than subjective assessment (p<0.001). The PC-FAAP was significantly more consistent in group I and group III (p<0.001 and p=0.002, respectively). FGS in group III was the only parameter that showed a more consistent result in PC-FAAP than the subjective scoring (p=0.008). Conclusions: An FNP grading system using a PC-based program may provide more consistent results, especially for severe forms.

Facial reanimation using the hypoglossal nerve and ansa cervicalis: a short-term retrospective analysis of surgical outcomes

  • Koo, Won Young;Park, Seong Oh;Ahn, Hee Chang;Ryu, Soo Rack
    • Archives of Craniofacial Surgery
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    • v.22 no.6
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    • pp.303-309
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    • 2021
  • Background: Transferring the hypoglossal nerve to the facial nerve using an end-to-end method is very effective for improving facial motor function. However, this technique may result in hemitongue atrophy. The ansa cervicalis, which arises from the cervical plexus, is also used for facial reanimation. We retrospectively reviewed cases where facial reanimation was performed using the ansa cervicalis to overcome the shortcomings of existing techniques of hypoglossal nerve transfer. Methods: The records of 15 patients who underwent hypoglossal nerve transfer were retrospectively reviewed. Three methods were used: facial reanimation with hypoglossal nerve transfer (group 1), facial nerve reanimation using the ansa cervicalis (group 2), and sural nerve interposition grafting between the hypoglossal nerve and facial nerve (group 3). In group 1, the ansa cervicalis was coapted to neurotize the distal stump of the hypoglossal nerve in a subset of patients. Clinical outcomes were evaluated using the House-Brackmann (H-B) grading system and Emotrics software. Results: All patients in group 1 (n= 4) achieved H-B grade IV facial function and showed improvements in the oral commissure angle at rest (preoperative vs. postoperative difference, 6.48° ± 0.77°) and while smiling (13.88° ± 2.00°). In groups 2 and 3, the oral commissure angle slightly improved at rest (group 2: 0.95° ± 0.53°, group 3: 1.35° ± 1.02°) and while smiling (group 2: 2.06° ± 0.67°, group 3: 1.23° ± 0.56°). In group 1, reduced tongue morbidity was found in patients who underwent ansa cervicalis transfer. Conclusion: Facial reanimation with hypoglossal nerve transfer, in combination with hypoglossal nerve neurotization using the ansa cervicalis for complete facial palsy patients, might enable favorable facial reanimation outcomes and reduce tongue morbidity. Facial reanimation using the ansa cervicalis or sural nerve for incomplete facial palsy patients did not lead to remarkable improvements, but it warrants further investigation.

A Retrospective Study of Facial Paralysis Sequelae for Korean Medical Treatment (말초성 안면마비 후유증에 대한 한방 치료를 위한 후향적 차트리뷰 연구)

  • Bae, Hyo-Bin;Yoon, Hwa-Jung;Ko, Woo-Shin
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.1
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    • pp.59-73
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    • 2019
  • Objectives : The purpose of this study is to confirm and to suggest the Korean medical treatment is effective treatments to patients with facial paralysis sequelae. Methods : We conducted a survey on patients with facial paralysis sequelae who visited the facial paralysis center from August 2017 to November 2018. We then evaluated House-Brackmann Grading System(HBGS), Sunnybrook Scale(S-Scale), Visual analog scale(VAS) against those who agreed and analyzed the information through Electronic Medical Record(EMR) and Order Communication System(OCS). Results : Clinically, Korean medical treatment such as embedding therapy are effective for the facial paralysis sequelae. For the purpose of raising the level of evidence against this, research will be needed to confirm the treatment effects by comparing accurate assessment indicators that are conducted before and after the treatment. Conclusions : In order to confirm the progress of treatment of facial paralysis sequelae, evaluation indicators such as House-Brackmann Grading System and Sunnybrook Scale should be performed by experts. And after 3-4 weeks, if patients have any sequelae symptoms, it may be helpful to take treatments such as pharmacopuncture treatment and embedding therapy at intervals of 1-2 weeks depending on the symptoms or areas.

The Clinical Study for Peripheral Facial Paralysis Treated with Herbal Stream Therapy (구안와사에 대한 훈증요법 복합치료 효과)

  • Kim, Ji-Soo;Park, Soo-Yeon;Choi, Chang-Won;Kim, Kyeong-Soo;Kim, Kyeong-Ok;Wei, Tung-Shuen;Yang, Seung-Joung
    • Herbal Formula Science
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    • v.23 no.1
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    • pp.151-159
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    • 2015
  • Objectives : This study was performed to investigate the effect of herbal steam therapy on peripheral facial paralysis. Methods : 55 patients with peripheral facial paralysis were treated with Korean Medicine therapy including herbal steam therapy. We evaluated the effect of Korean Medicine therapy including herbal steam therapy by Yanagihara grading system. Results : 1. 55 patients were treated with Korean Medicine therapy and 23.27±14.11 times of herbal steam therapy. 2. After treatment, Y-system score was significantly increased(p-value<0.001) from 18.00±6.5514 to 35.00±6.3404. Conclusions : Herbal stream therapy seem to be effective to improve symptoms of peripheral facial paralysis. Further studies will be needed to identify the beneficial of herbal steam therapy on peripheral facial paralysis.

The Clinical Study for Peripheral Facial Paralysis Treated with Herbal Stream Therapy (훈증요법을 병행한 말초성 안면신경마비 환자에 대한 임상적 고찰)

  • Park, Soo-Yeon;Kim, Ji-Soo;Jeong, Min-Young;Kim, Jong-Han;Choi, Jeong-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.27 no.4
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    • pp.131-140
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    • 2014
  • Objective : This study was performed to investigate the effect of herbal steam therapy on peripheral facial paralysis. Method : 33 patients with peripheral facial paralysis were treated with Korean Medicine therapy including herbal steam therapy. We evaluated the effect of herbal steam therapy by Yanagihara grading system and satisfaction measurement. Results : 1. 33 patients were treated with korean medicine therapy and $27.85{\pm}16.44$ times of herbal steam therapy. 2. After treatment, Y-system score was significantly increased(p-value<0.001) from $18.45{\pm}6.5196$ to $35.42{\pm}5.2501$. 3. 87.88% of patients was satisfied with herbal steam therapy. Conclusions : Herbal stream therapy seem to be effective to improve symptoms of peripheral facial paralysis. Further studies will be needed to identify the beneficial of herbal steam therapy on peripheral facial paralysis.

A Clinical Study about General Characteristics, Treatment Progress and Obesity-underweight of Idiopathic Facial Paralysis (Bell's palsy) (특발성 안면신경마비 환자의 일반적 특성 및 치료경과와 비수(肥瘦)에 따른 임상적 고찰)

  • Jung, Yu-Sun;Jang, Soo-Young;Shin, Hyeon-Cheol
    • The Journal of Internal Korean Medicine
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    • v.34 no.1
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    • pp.86-99
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    • 2013
  • Objectives : The purpose of this study was to analyze the general features of patients with idiopathic faical paralysis. Methods : We investigated the various features and HBGS (House-Brackmann Grading System) of 505 patients who were diagnosed with idiopathic facial paralysis. Results and Conclusions : 1. The sex distribution was 264 male cases, and 241 female cases, and the majority of them were in their 40s. 2. Overwork was the most frequent contributing factor to their paralysis. 3. The treatment of most patients was completed within 2 months. 4. Their recovery was faster if their first hospital visit was sooner and their paralysis was partial. On average, the patients recovered within 19.5 to 27.8 days and it took much less time than natural recovery. 5. When looking at the BMI of the selected patients for this study, 62.00% were obese while 14.37% were under-weight. Among the obese patients, there were more with Xu mai (虛脈) than Shi mai (實脈). For the under-weight patients, most had Shuo mai (數脈) while none had Chi mai (遲脈).

The Clinical Observation on 3 Cases of Facial Palsy Following Microvascular Decompression in Hemifacial Spasm Patients (편측안면경련 환자에서 미세혈관 감압수술 후 발생한 구안와사 환자 3례)

  • Kim, Jong-In;Choi, Yang-Sik;Kim, Haeng-Beom;Kim, Joo-Hee;Lee, Ro-Min;Kim, Kun-Hyung;Lee, Jae-Dong;Kang, Sung-Keel;Koh, Hyung-Kyun
    • Journal of Acupuncture Research
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    • v.23 no.6
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    • pp.229-238
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    • 2006
  • Background and Objetive : The aim of this study is to report 3 cases of facial palsy following microvascular decompression in hemifacial spasm patients. It is a rare disease, with few research on the effect of acupuncture therapy on it. Material and Method : We selected 3 cases of facial palsy following microvascular decompression in hemifacial spasm patients, among patients who visited the Facial palsy Clinic of Kyunghee Oriental Medical Center. We treated them with acupuncture therapy(ST6, ST4, BL2, TE17, GV24, GV14, and Ex-HN4 of the healthy side, and LI4 and ST36 of both sides) and aroma therapy. After treatment we observed and checked any changes within clinical symptoms using the House-Brackmann Grade and the Yanagihara's Unweighted Grading System. Result and Conclusion : 1. All three cases were of hemifacial spasm patients who had facial palsy following microvascular decompression. The patients visited 27 months(Case1), 2 months(Case2) and 7 months(Case 3) after the surgery respectively. 2. Period of time till complete recovery is 23 months(Case1), 8 months(Case2) and 3 month (Case3) respectively. 3. All three cases had symptoms of sequelae: retraction of mouth toward the healthy side and involuntary spasm of lips. The later the initiation of treatment after the sugery, the more severe symptoms of sequelae.

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The Effect of Needle-Embedding Therapy on Peripheral Facial Paralysis (말초성 안면신경마비에 대한 매선요법 복합치료 효과)

  • Kim, Ji-Soo;Park, Soo-Yeon;Kim, Kyeong-Soo;Kim, Kyeong-Ok;Wei, Tung- Shuen;Choi, Chang-Won;Yang, Seung-Joung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.28 no.2
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    • pp.45-53
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    • 2015
  • Objective : This study was performed to investigate the effect of Needle-Embedding Therapy on peripheral facial paralysis. Method : We investigated 60 cases of patients with peripheral facial paralysis, and devided patients into two groups : We treated one group by complex korean medical treatment with Needle-Embedding therapy, and did the other group by complex korean medical treatment without Needle-Embedding therapy. Yanagihara grading system at baseline and final were used for evaluating the effect of the treatment. Results : 1. In Needle-Embedding therapy group and non Needle-Embedding therapy group, compared with baseline, at final, Y score was significantly increased.2. At final, there was significant difference in improvement between Needle-Embedding therapy group and non Needle-Embedding therapy group. Conclusions : Needle-Embedding therapy seem to be effective to improve symptoms of peripheral facial paralysis. Further studies will be needed to identify the beneficial of Needle-Embedding therapy on peripheral facial paralysis.

Comparative Clinical Study between Oriental Medicine and Oriental-Western Medicine Treatment on Bell's palsy (특발성 말초성 안면신경마비(Bell's Palsy)에 대한 한방치료와 양방병용치료의 비교 고찰)

  • Kim, Nam-Ok;Chae, Sang-Jin;Son, Sung-Se
    • Journal of Acupuncture Research
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    • v.18 no.5
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    • pp.99-108
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    • 2001
  • Objective : Lately variable oriental-western medicine treatment have been used for Bell's palsy. The purpose of this study is comparison of clinical treatment outcome between oriental medicine group and oriental-western medicine group. Materials and Methods : From 08-01-2000 to 07-30-2001, 30 Bell's palsy out-patients who visited within 5days after onset and treated more than 3weeks at the Department of Acupuncture & Moxibustion, Bundang CHA Oriental Medicine Hospital were selected for two groups. One group(A group) was treated by oriental medicine therapy(Acupunture, Herb, Physical therapy), the other group(B group) was treated by oriental-western medicine therapy(Acupunture, Herb, Physical therapy, Administration of prednison). Two group was composed of 15 patients respectively and measured by HBGS(House-Brackmann Grading System) and DEFS(Detailed Evaluation of Facial Symmetry of Pillsbury and Fisch) at first visit and 3weeks after. Result and Conclusion : A group was marked more higher than B group in treatment outcome. But we discovered that it is not significant differences between two groups.

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A Case Report of Herpes Zoster Oticus (이성대상포진의 치험1례)

  • Jo, Seong-Ho;Lee, Gil-Yeong
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.14 no.1
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    • pp.76-86
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    • 2001
  • Herpes zoster oticus which is called Ramsay Hunt syndrome, geniculate ganglion herpes and otic herpes, is characterized by a viral prodrome with otalgia, vesicular eruptions, facial paralysis, hearing disturbance, tinnitus, vertigo and other symtoms. Among cranial nerves, trigeminal and facial nerves are the most commonly affected in patients with herpes zoster oticus, but on rare occasions 8th, 9th, 10th, 11th, 12th cranial nerves and even the upper cervical nerve are influenced as well.. In general, it has poor prognosis compared with Bell's palsy, leaving permanent facial nerve dysfunction. We report a case of Herpes zoster oticus, which was fully recovered by acupuncture and herbal medication within 12 days. We used $FEMA^{11)}$ and House-Brackmann's grading system to assess the degree of paralysis in each part of face.

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