• 제목/요약/키워드: facial paralysis

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Masseter nerve-based facial palsy reconstruction

  • Park, Hojin;Jeong, Seong Su;Oh, Tae Suk
    • 대한두개안면성형외과학회지
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    • 제21권6호
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    • pp.337-344
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    • 2020
  • Facial paralysis is a devastating disease, the treatment of which is challenging. The use of the masseteric nerve in facial reanimation has become increasingly popular and has been applied to an expanded range of clinical scenarios. However, appropriate selection of the motor nerve and reanimation method is vital for successful facial reanimation. In this literature review on facial reanimation and the masseter nerve, we summarize and compare various reanimation methods using the masseter nerve. The masseter nerve can be used for direct coaptation with the paralyzed facial nerve for temporary motor input during cross-facial nerve graft regeneration and for double innervation with the contralateral facial nerve. The masseter nerve is favorable because of its proximity to the facial nerve, limited donor site morbidity, and rapid functional recovery. Masseter nerve transfer usually leads to improved symmetry and oral commissure excursion due to robust motor input. However, the lack of a spontaneous, effortless smile is a significant concern with the use of the masseter nerve. A thorough understanding of the advantages and disadvantages of the use of the masseter nerve, along with careful patient selection, can expand its use in clinical scenarios and improve the outcomes of facial reanimation surgery.

적외선 체열진단을 이용한 안면마비와 안면과 상지에 분포한 경혈위와의 관계에 대한 임상고찰 (A clinical study on the relation between facial paralysis and acupoints on the face and the upper limbs by the use of DITI diagnosis)

  • 김진원;정병주;김용호;서호석;황규동;손지형;한승혜
    • 대한한방내과학회지
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    • 제25권4호
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    • pp.140-146
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    • 2004
  • Objectives : this study is to see if there is a significance in thermal differences of acupoints in diagnosis and treatment period of facial paralysis and to substantiate the validity of acupuncture and moxibustion treatment for it. Methods : 1. By using DITI, thermal differences of acupoints on the face and the upper limbs of 13 Bell's palsy patients were measured around 3 days after an attack of the disease. These 13 patients, whose treatment progress was monitored up to 6 months after attack, were among the inpatients and outpatients of oriental internal medicine of National Medical Center from July 1 to August 31. 2. The patients were divided into 1month, 2-3months, 4months, 6months groups according to the occasion of improvement and thermal averages of each treatment period measured. Results : When it takes within 1 month for the condition of facial paralysis to change for the better, DITI image shows the temperature of the affected face parts and arms is higher than that of the non-affected parts. However, when it takes more than 4 months, the temperature of the affected face parts and arms on DITI image is lower than that of the non-affected parts. Conclusions : Hereby, prognosis of the disease and necessary time for the treatment can be presumed through DITI screening after an occurrence of facial paralysis. Also, condition of the disease is reflected by thermal differences of acupoints for Bell's palsy treatment that are in accordance with the theory of meridian on the face. This supports the efficacy of acupuncture and moxibustion treatment for this disease.

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구안와사(口眼喎斜) 환자 254명에 대한 감리적(臨床的) 고찰(考察) (Clinical Studies on 254 Cases of Patient with Facial Paralysis)

  • 옥민근;임웅경;김창환;박수은
    • 한방안이비인후피부과학회지
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    • 제18권3호
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    • pp.75-83
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    • 2005
  • Objective: The purpose of this study is to investigate the clinical studies on 254 cases of patient with facial paralysis. Methods: We examined the sex, age, region, month, season, physical condition, attened symptoms, the period before admission, the period of treatment the times of treatment, the point of the recovery Results: 1. The distribution of sex was male 119 cases, female 125 cases(1.032:1). The distribution of age was disclosed that fifty was the most in 53 cases(20.9%) 2. In distribution of the region of facial palsy, the ratio of the male-left was 27.6%(70 cases), female-left was 24.4%(62cases), male-right was 23.2%(59 cases), female-right was 24.8%(63 cases). 3. In distribution of contributing frequence in month, January was the most in number(29 cases, 11.4%), In distribution of contributing number in season winter was the most in number(76 cases, 29.9%). 4. In distribution of physical condition, fatigue(99 cases, 40.0%), stress(66 cases 26.0%), cold exposure(43 cases, 16.9%) were investigated highly than other conditions. 5. In distribution of attended symptoms, stylomastoid pain(91 cases, 35.8%), tears(40 cases 15.7%). taste paralysis(29 cases, 11.4%) were investigated highly than other symptoms. 6. In distribution of the period before admission in descending order the first under the third day was the most number in 92 cases(62.2%), over two weeks 22 cases(14.9%) 7. In distribution of the period of treatment, over eight weeks was the most number in 91 cases(35.8%), under a week in 50 cases(19.7%). In distribution of the times of treatment under five times was the most number in 56 cases(14.2%). 8. In distribution of the point of the recovery, under two weeks was the most number in 77 cases(52%).

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Nasolabial Angle 관찰을 통한 구완와사 후유증의 표정근 불균형에 대한 임상적 고찰 (A Clinical Study to Observe Nasolabial Angle on Facial Palsy Sequelae by Disproportional Muscles of Expression)

  • 윤인환;김남권
    • 대한한의학회지
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    • 제29권3호
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    • pp.131-143
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    • 2008
  • Objectives: Electroacupuncture has the effect of recovering paralytic nerves and muscles. To treat disproportional muscles of expression with electroacupuncture, it is essential that we know the correct point of paralytic muscle. Methods: We investigated 20 cases of patients with facial palsy sequelae. We measured nasolabial angles, checked grade of muscle palsy, and tested ENoG. Results: This study showed significant correlation between nasolabial angles with these muscle groups (zygomatic group I, zygomatic group II, orbicularis oris muscle). Conclusions: Disproportional facesare fixed by muscles of expression observed in facial palsy sequelae. We can treat muscular paralysis of these muscle groups with electroacupuncture for more complete recovery.

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New Treatment in Facial Nerve Palsy Caused by Sagittal Split Ramus Osteotomy of Mandible

  • Lee, Jin Hoon;Lee, Kyung Ah
    • 대한두개안면성형외과학회지
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    • 제18권1호
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    • pp.65-70
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    • 2017
  • A 25-years-old woman with mandibular prognathism underwent a mandibular setback by way of mandibular sagittal split ramus osteotomy (MSSRO). After 2 days of operation, she developed difficulty of closing her right eye. The blink reflex test and motor nerve conduction study of the right orbicularis oris muscle were revealed right facial neuropathy of unknown origin and House-Brackmann facial nerve grading system (HBFNGS) grade V. For treatment, we initially prescribed oral prednisolone and nimodipine including physical therapy. The samples consisted of 11 facial nerve palsy patients caused by MSSRO and were analysed about onset of facial nerve palsy, postoperative HBFNGS, final HBFNGS, treatment method and recovery time. At 10 weeks of treatment of nimodipine, she had completely regained normal function (HBFNGS grade I) of the right facial nerve. The clinical results lead to assume a fast recovery of facial nerve function by the nimodipine medication, whereas average time of recovery is 16.32 weeks in references. Despite of the limited one patient treated, the result was very promising with respect to a faster recovery of the facial nerve function. Considering the use of nimodipine treatment for peripheral facial nerve palsy following a surgical approach with an anatomically preserved nerve can be recommended.

안면비대칭 평가를 위한 Nottingham Grading System의 문제점 개선 (Improvement of Nottingham Grading System for Facial Asymmetry Evaluation)

  • 이민우;장민;김진아;신상훈
    • 재활복지공학회논문지
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    • 제11권2호
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    • pp.179-186
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    • 2017
  • 안면 비대칭은 다양한 원인에 의해 발병되기 때문에 원인 분석이 중요하고, 평가하는데 있어서 정량적인 지표가 필요하다. 본 연구에서는 웹켐을 이용하여 얻은 영상을 영상처리 및 연산부를 거쳐 마커를 추적하고 마커 간의 거리를 계산하여 안면 마비를 평가하는데 정량적인 지표로 사용하던 Nottingham Grading System을 안면 비대칭을 평가하는데 적용해 보았다. 기존 Nottingham Grading System은 표정 변화에 따른 안면부의 특징점 들간의 거리변화를 합산하여 좌, 우를 비교하기 때문에 특정 케이스의 경우 측정 오류를 불러일으키는 문제점이 있었다. 기존 Nottingham Grading System과 문제점을 보완하여 개선시킨 평가지표를 이용하여 안면비대칭인 피실험자와 정상의 피실험자를 비교하였다. 기존 Nottingham Grading System에서는 안면 비대칭의 경우 99.0%, 정상의 경우 95.0%로 둘 다 정상 범위 속에 포함되었다. 하지만 개선시킨 Nottingham Grading System에서는 안면 비대칭의 경우 74.0%, 정상의 경우 93.2%의 결과가 나왔다. 본 연구의 결과로 인해, 개선시킨 Nottingham Grading System은 각 부위별 상세한 평가 및 진단이 가능하고, 기존 Nottingham Grading System의 '문제점을 보완하였음을 보여주었다.

흰쥐 안면신경핵 세포의 전기생리학적 및 형태학적 특성 (ELECTROPHYSIOLOGICAL AND MORPHOLOGICAL CHARACTERISTICS OF FACIAL NUCLEUS IN RAT)

  • 최병주;조진화;배용철;김영진
    • 대한소아치과학회지
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    • 제27권3호
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    • pp.400-409
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    • 2000
  • 흰쥐의 안면신경핵을 구성하는 신경세포들의 시냅스 연결 양태 및 세포막 특성을 규명하기 위해 in vivo 필드전위 및 세포 내 전위 측정법을 이용하여 전기생리적 반응을 관찰하였다. 말초 안면신경 분지를 역행성으로 전기자극시 자극세기에 비례하여 전위의 크기가 증가되었고 필드 전위의 양태는 두 가지 반응으로 나타났는데 전기자극 직후 1ms 부근에서 정점을 나타내는 양태와 이와 더불어 $7\sim8ms$ 부근에서 후기 정점을 동반하는 양태가 있었다. 안면신경핵은 염색시 내측, 배외측, 중간측 및 외측등 4부분의 소핵으로 구분되었다. Neurobiotin으로 채워진 단일 신경세포를 형태학적으로 재구축하였는데 세포체는 추체형태를 나타내었고 주 수상돌기는 모든 방향으로 뻗어져 있었고 각 수상돌기의 영역은 해당 소핵 내에 한정되어 있었다. 일련의 과분극 전류 $(-1.2\sim+1.2nA)$를 세포내에 가하였을 때 동반되는 세포내 전위변화를 입력저항 값으로 계산하였을 때 그 기울기가 직선형으로 나타났다. 탈분극 전류를 세포내 주입시 지속적인 활동성 전위가 나타났으며 전류의 크기에 비례하여 각 전위의 개수가 증가하였고 spike-빈도 적응 현상이 나타났다. 그러나 시간 의존성 내향성 정류현상은 관찰되지 않았고 anodal break excitation이 나타났다. 이상의 실험결과로 보아 안면신경핵을 구성하고 있는 세포들 사이의 시냅스는 다양한 형태로 존재할 가능성이 있다고 사료되며 이들 시냅스간의 변화를 통하여 안면 신경마비, 반쪽 안면 경련, hypoglossal-facial anastomosis등에서 나타날 수 있는 임상적 신경성 증상 기전을 설명할 수 있을 것으로 여겨진다.

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Ramsey Hunt 증후군의 치험 -1예 보고- (Ramsey Hunt Syndrome -A case report-)

  • 사희순;김태헌
    • The Korean Journal of Pain
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    • 제1권1호
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    • pp.103-105
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    • 1988
  • Ramsey Hunt Syndrome occurs when herpes zoster afters the facial nerve. It causes vesicular eruption of the pinna, external auditory meaturs and ear drum, severe otalgia with associated facial paralysis and vertigo. We experienced a case of Ramsey Hunt syndrome and managed it with repeated sympathetic blocks using a stellate ganglion block. We achieved early resolution of the eruption, relief of pain and prevention of postherpetic neuralgia. We concluded that SGB was effective treatment against Ramsey Hunt Syndrome.

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Management of Otogenic Brain Abscess Using the Transmastoid Approach

  • Choi, June;Choi, Jong Il;Kim, Sang-Dae
    • Journal of Korean Neurosurgical Society
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    • 제55권3호
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    • pp.178-180
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    • 2014
  • Despite significant advances in the treatment of all forms of chronic otitis media (COM), complications still can and do occur, with intracranial complications representing the most life-threatening cases, often requiring immediate therapeutic intervention. Herein, we present a rare case of rapidly progressing facial paralysis with concomitant severe headache and ipsilateral hearing loss secondary to an otogenic brain abscess, treated with the transmastoid approach, drainage, and facial nerve decompression.

안면근육마비 환자 사전진단 시스템 개발에 관한 연구 (A Study for Facial nerve palsy Patient Pre-Diagnosis System Development)

  • 이선영
    • 한국정보처리학회:학술대회논문집
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    • 한국정보처리학회 2012년도 추계학술발표대회
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    • pp.665-667
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    • 2012
  • 안면신경마비(facial nerve paralysis)는 주로 편측성으로 발생하는 안면신경장애에 의한 안면표정근의 마비를 뜻한다. 이러한 안면신경마비는 중추성 안면신경마비와 말초성 안면신경마비 두 가지로 나뉜다. 안면신경마비의 증상으로는 이환측, 구각부의 처짐 및 침을 흘리는 등 입 주위의 증상이 있어 안면표정의 변화를 일으킨다.[1] 본 논문은 사진을 입력 받아 얼굴영역에서 입 특징점을 추출하여 입력 받은 데이터가 안면신경마비 환자인지 아닌지 판단하고자 한다.