• Archives of Plastic Surgery
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• v.38 no.1
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• pp.81-84
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• 2011

Purpose: Nerve injury is one of the complication which can develop after brow lift. Peripheral nerve ending which is stretched from supraorbital nerve and supratrochlear nerve can be injured and symptoms such as pain, dysesthesia may appear. Usually, developed pain disappeared spontaneously and does not go on chronic way. We experienced a case that a patient complained chronic pain after brow lift which was not controlled by conservative management such as medications, local nerve block and report a successful surgical treatment of chronic pain after brow lift. Methods: A 24-year-old male who received brow lift with hairline incision at local hospital was admitted for chronic pain at the right forehead. The pain was continued for 3 months even though fixed thread was removed. Local nerve block at trigger point with mixed 1 mL 2% lidocaine and 1 mL Triamcinolone acetonide was done and oral medications, Gabapentine and carbamazepine, were also applied but there was no difference in the degree of pain. Therefore the operation was performed so that careful dissection was carried out at right supraorbital neurovascular bundle and adhered supraorbital nerve was released from surrounding tissues and covered with silastic sheet to prevent adhesion. Results: The pain was gradually relieved for a week. The patient was discharged without complications. No evidence of recurrence has been observed for 2 years. Conclusion: The pain developed after brow lift was engaged with nerve injury and sometimes remains chronically. Many kinds of conservative management to treat this complication such as medications, local nerve block have been reported and usually been used. But there are some chronic cases that conservative treatment do not work. In sum, we report 1 case of successful surgical treatment for relief of intractable pain developed after brow lift surgery.

• The Korean Journal of Pain
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• v.14 no.2
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• pp.266-270
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• 2001

An 85-year old female patient visited our pain clinic because of pin pricking pain and allodynia on the left forehead area for 2 days. Vesicular eruptions were seen along the left supraorbital nerve distribution. She experienced similar pain and eruptions on the contralateral forehead, the supraorbital counter area, 8 years previous. She had been taking antihypertensive medications for 15 years. She also had suffered from diabetes mellitus. She received a total hysterectomy and anterior posterior colporrhapy due to procidentia uteri and severe cystocele and rectocele. She had been treated intermittently for back pain due to advanced osteoarthritis and spondylosis. She was treated with famciclovir and triamcinolone acetonide with daily stellate ganglion block and supraorbital nerve block. Nortriptyline (a tricyclic antidepressant) and midazolam was prescribed to relieve pain and difficulty in sleeping. After 3 days, all treatment was ended because it was impossible to assess the severity of pain due to the senile psychosis of the patient. She eventually expired after 2 months. We report this case because it is rare for herpes zoster to recur, and particularly on the contralateral counter area.

• The Korean Journal of Pain
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• v.22 no.2
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• pp.167-170
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• 2009

Pharmacological management is the first choice for treatment of the trigeminal neuralgia patients; however, if this mode of treatment fails a minimally invasive procedure should be performed. One of the most commonly used procedures is conventional radiofrequency lesioning of the Gasserian ganglion. Despite its popularity and success rate, this technique has disadvantages such as diminished corneal reflex, masseter weakness, numbness and anesthesia dolorosa. As a result, many studies have been conducted in an attempt to find a better method of treating trigeminal neuralgia. We report here a case of a trigeminal neuralgia patient that was treated with pulsed radiofrequency lesioning of the supraorbital and supratrochlear nerve due to pain in the frontal head that was refractory to the pharmacological treatments. Following the procedure, the Visual Analogue Scale score for pain decreased to 1-2/10 and the pain relief persisted for 7 months. These results indicate that pulsed radiofrequency treatment of the peripheral nerve may be useful for trigeminal neuralgia patients that do not respond to pharmacological treatments.

• The Korean Journal of Pain
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• v.26 no.2
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• pp.130-134
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• 2013

Background: The aims of this study were to analyze the anatomic variations of supraorbital foramina/notches in Koreans and to compare the results with those of previous studies examining other races. We evaluated the three-dimensional computed tomography (3D-CT) images of human faces using multidetector computed tomography (MDCT). Methods: A total of 395 adults (232 men and 163 women) were enrolled and the 3D-CT images of their faces were reviewed in this study. In this study, the data from the images included the presence, shape, width and distance from the nasion to the supraorbital foramina/notches. ANOVA was used to assess the main effects of gender and side (right or left foramen/notch), and comparisons of the means were done by paired t-test. Results: The most common shapes in Koreans were a single notch (39.5%) on the right hand side and a single foramen (42.3%) on the left hand side. The incidence of a single foramen in Koreans was high compared to other races. The mean foramen diameter was $2.34{\pm}0.78$ mm, and the mean distance from the nasion was $27.19{\pm}4.03$ mm. The mean notch diameter was $3.37{\pm}1.71$ mm, and the mean distance from the nasion was $23.42{\pm}2.45$ mm. Conclusions: This is the first study on the variations of supraorbital foramina/notches in Koreans using 3D-CT images of faces. The anatomic characteristics of the supraorbital foramina/notch will help in performing nerve blocks and maxillofacial surgery.

• The Journal of Korean Medicine
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• v.16 no.2 s.30
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• pp.447-452
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• 1995

The meridians pathway on the hand and neck studies connection with craniospinal nerve to obtain result fellowing items. 1. Large Intestine Meridian of Hand-yang ming, Small Intestine Meridian of Hand-tai yang. Triple Warmer Meridian of Meridian of Foot-tai yang, was hollow organs and its had connected branches of the trigeminal nerve and fasial nerve, cervical nerve plexus. 2. The Triple warmer meridian pathway around ear connection supersecial temporlal branch. zygomatic branch. buccal branch mandlibular branch, cervical branch of the fasial nerve. 3. The stomach meridian foot-yang ming orginate from the glabella of the frontal bone, and connection supraorbital, frontal branches of the opthalamic nerve in headach. 4. The original cell of the trigeminal nerve, and fasial nerve the medulla oblongata and pons.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.17 no.3
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• pp.233-240
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• 2013

Objectives The objective and universal grading system for the facial nerve palsy is needed to the objectification of treatment in Oriental medicine. In this study, the facial nerve palsy grading was developed with combination of image processing technique and Nottingham scale. Methods The developed system is composed of measurement part, image processing part, facial nerve palsy evaluation part, and display part. With the video data recorded by webcam at measurement part, the positions of marker were measured at image processing part. In evaluation part, Nottingham scales were calculated in four different facial expressions with measured marker position. The video of facial movement, time history of marker position, and Nottingham scale were displayed in display part. Results & Conclusion The developed system was applied to a normal subject and a abnormal subject with facial nerve palsy. The left-right difference of Nottingham scores was large in the abnormal compared with the normal. In normal case, the change of the length between supraorbital point and infraorbital point was larger than that of the length between lateral canthus and angle of mouth. The abnormal case showed an opposite result. The developed system showed the possibilities of the objective and universal grading system for the facial nerve palsy.

• Archives of Craniofacial Surgery
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• v.17 no.1
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• pp.39-42
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• 2016

Forehead osteomas are benign but can pose aesthetic and functional problems. These osteomas are resected via bicoronal or endoscopic approach. However, large osteomas cannot be removed via endoscopic approach, and bicoronal approach can result in damage to the supraorbital nerve with resultant numbness in the forehead. We present a new approach to resection of forehead osteomas, with access provided by an anterior hairline incision and subcutaneous dissection. Three patients underwent resection of the forehead osteoma through an anterior hairline incision. The dissection was carried in the subcutaneous plane, and the frontalis muscle and periosteum were divided parallel to the course of supraorbital nerve. The resulting bony defect was re-contoured using $Medpor^{(R)}$. All three patients recovered without any postoperative infection or complication and symptoms. Scalp sensory was preserved. Aesthetic outcomes were satisfactory. Patients remain free of recurrence for 12 months of follow up. The anterior hair line approach with subcutaneous dissection is an effective method for removal of forehead osteoma, since it offers broad visualization and hides the scar in the hairline. In addition, the dissection in the subcutaneous plane avoids inadvertent injury to the deep nerve branches and helps to maintains scalp sensation.

• Archives of Craniofacial Surgery
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• v.20 no.6
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• pp.421-424
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• 2019

Osteomas are benign, slow-growing osteogenic lesions frequently found in the craniomaxillofacial region. They can be classified as peripheral, central, or extraskeletal. Reactive mechanisms to trauma or infection, as well as muscle traction, are thought to play a major role in the development of peripheral osteomas. In the present report, a 41-year-old woman presented with a slowgrowing, painless mass on her left eyebrow. She had suffered trauma 15 years prior. In the computed tomography scan, a 2.5×2×0.7-cm radio-opaque tumor was detected just medial to the left supraorbital foramen, and a peripheral osteoma was clinically diagnosed. An elective operation under general anesthesia was planned. Following a suprabrow incision, subcutaneous and intramuscular dissection was performed. In the surgical plane deep to the corrugator muscles and superficial to periosteum, a branch of the supratrochlear nerve was encountered and preserved using a vessel loop. The osteoma beneath the periosteum was extracted in multiple fragments using a chisel and mallet to minimize trauma to the nerve. Contour and facial symmetry were corrected. To use a suprabrow incision, the surgeon must understand neighboring anatomical structures, including the course of the supratrochlear and supraorbital neurovascular bundles. When these structures are located adjacent to tumor lesions, careful surgical maneuvers should be performed to preserve them.

• Archives of Plastic Surgery
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• v.36 no.2
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• pp.205-210
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• 2009

Purpose: Corrugator supercilii muscle pulls eyebrow to inferomedial direction and produces the vertical component of the glabellar line formation. Current techniques for eliminating of glabellar frown include direct resection of corrugators and botulinum toxin injection. Muscle resection in endoscopic face lift procedure is relatively complex and has many disadvantages ranging from possible nerve injury, postoperative edema, pain and a long recovery period. The Botox treatment on the other hand is much more simple in technique but has a short duration of action. The authors have attempted new ways of finding improved treatment of the glabellar frown by selectively blocking of motor nerves innervating the corrugator supercili muscle by using radiofrequency ablation technique. Methods: A total of 80 patients were recruited in our study during the period between Feb. 2007 to June 2008. A probe was introduced from the supraorbital ridge and advanced to the corrugator supercilii muscle. Nerve stimulator was then used to locate the nerve innervating the corrugator and radiofrequency ablation of the nerve was done. Results: In all patients, there were marked improvement in glabellar frown after treatment. There were no reported cases of any relapses during the follow up period. No complication was noted such as facial nerve injury. No patient complained of any adverse symptoms other than slight discomfort due to swelling of the operation site. Conclusion: The treatment of glabellar frown lines using selective nerve block with radiofrequency ablation was not only less invasive but also excellent in surgical outcomes.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.45-50
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• 2006

Background: Recently trigeminal nerve block with alcohol (TnbA) for the treatment of trigeminal neuralgia (TN) has come to be known as a procedure with a short-term effect and high complications. There has been none of report about long-term outcome of TnbA for TN. The objective of this prospective study for the long-term results of TnbA was to analyse the pain free duration and complication after the administration of blocks and compare them in the first block and subsequent blocks. Methods: From March 1996 to May 2005, 304 consecutive patients with primary trigeminal neuralgia were treated with TnbA including supraorbital nerve block, infraorbital nerve block, maxillary nerve (V2) block, mandibular nerve (V3) block, and V2 and V3 at the same time and were prospectively followed up every two months for 10 years. Results: The mean value of pain free duation of 1st, 2nd and 3rd TnbA were 43, 38 and 48 months, respectively using Kaplan-Meier analysis. The probability of pain recurrence in 1 and 3 years after the 1st, 2nd and 3rd blocks were 25%, 25%, 20% and 53%, 54%, 34%, respectively. The pain free durations of first and subsequent blocks were not statistically different. Complications were reported at 36 (11.8%), 5 (4.2%), and 0 in 1st, 2nd and 3rd blocks. Conclusions: TnbA showed the relatively long duration of pain free and low incidence of complications. Repeated TnbA has pain free duration as long as the 1st block and less complications as well. TnbA is a valuable treatment of TN as a percutaneous procedure.