BACKGROUND AND OBJECTIVES: Since Sir Charles Bell (1829) demonstrated that motor innervation of the muscles of facial expression is by cranial nerve VII, many more research have contributed to the diagnosis and treatment of facial nerve paralysis. We attempted to evaluate the causes, arrive at accurate diagnosis and determine the treatment for facial nerve paralysis. MATERIALS AND METHODS: The authors analyzed 65 cases of facial nerve paralysis diagnosed at the Department of Otolaryngology, Hanyang University Hospital from January 1993 to December 1995. RESULTS: 1) The most common age group was the twenties. 2) The most common cause was trauma (23 cases, 35.4%). 3) The degree of facial nerve paralysis that were most common on first visits was Grade IV, based on the House-Brackmann grading method. 4) 38 cases (58.5%) were treated with chemotherapy and 27 cases (41.5%) were treated with surgical therapy. 5) Surgical techniques used were facial nerve decompression in 11 cases (40.8%), end to end anastomosis in 4 cases (14.8%), myringotomy with v-tube insertion in 4 cases (14.8%), tumor resection in 3 cases (11.1%), nerve graft in 2 cases (7.4%), mastoidectomy only in 2 cases (7.4%), and muscle transposition in one case (3.7%). CONCLUSION: In our review, the the most common degree of facial nerve paralysis on patients' first visits was Grade IV according to the House-Brackmann grading method. Statistically, there was no sexual difference in the incidences of facial nerve pals. The causes of facial nerve palsy due to trauma are recently on the rise because of increased traffic accident. However, iatrogenic incidents are decreasing because of the advance in the technical and instrumental development.
Accidents, Traffic ; Decompression ; Diagnosis ; Drug Therapy ; Facial Expression ; Facial Nerve* ; Humans ; Incidence ; Muscles ; Otolaryngology ; Paralysis* ; Transplants

This paper introduces the specific clinical experience of professor
Acupuncture Points ; Acupuncture Therapy ; Facial Paralysis/drug therapy* ; Herbal Medicine ; Humans ; Moxibustion

Child, Preschool ; Facial Paralysis ; etiology ; Female ; Hand, Foot and Mouth Disease ; complications ; drug therapy ; Humans

Leukemic involement of the temporal bone is not uncommon, but facial paralysis is rare as the presenting sign. A 16-year-old boy suddenly developed otalgia, facial nerve paralysis, tinnitus and vertigo. Four months ago, acute myelogenic leukemia was detected and chemotherapy was done with incomplete resolution. The initial examination revealed facial nerve paralysis, mixed hearing loss, spontaneous nystagmus but peripheral blood picture was normal. On the fourth hospital day, simple mastoidectomy was performed for drainage and diagnosis. The harvested tissue showed leukemic infiltration and subsequent peripheral blood picture revealed immature cells. Patient refused further evaluation and chemotherapy, and three months later he died of intracranial hemorrhage. We report a case of acute myelogenic leukemia with facial nerve paralysis.
Adolescent ; Diagnosis ; Drainage ; Drug Therapy ; Earache ; Facial Nerve* ; Facial Paralysis ; Hearing Loss, Mixed Conductive-Sensorineural ; Humans ; Intracranial Hemorrhages ; Leukemia* ; Leukemic Infiltration ; Male ; Paralysis* ; Temporal Bone ; Tinnitus ; Vertigo

Professor HE Tianyou's unique understanding and treatment characteristics for intractahle facial paralysis are introduced. In clinical practice professor HE highly values acupoint selection and manipulation application, and integrates Chinese and western medicine to flexibly choose acupoints and formulate prescriptions according to syndrome differentiation and location differentiation, besides, he creates several specialized manipulation methods including "tug-of war opposite acupuncture method" and "tractive flash cupping". Based on strengthening body and dredging collaterals. more attention is given on stimulation to local paralyzed facial nerves; meanwhile acupuncture and medication are combined to improve clinical efficacy. During the treatment, the important role of psychological counseling on patient's anxiety is emphasized, and comprehensive treatment is given physically and psychologically in order to achieve the purpose of total rehabilitation.
Acupuncture Points ; Acupuncture Therapy ; Adult ; Drugs, Chinese Herbal ; administration & dosage ; Facial Paralysis ; drug therapy ; therapy ; Female ; Humans ; Medicine

Primary central nervous system atypical teratoid/rhabdoid tumors are rare and extremely aggressive malignancies of early childhood. These tumors are most common in infants less than 2 years of age. Diagnosis is based on distinctive light microscopic and immunohistochemical findings, coupled with a molecular genetic analysis. A histologic features of these tumors are epithelial and/or mesenchymal components in addition to rhabdoid, with or without neuroepithelial fields. The expression of the epithelial membrane antigen, vimentin, and the smooth muscle actin are characteristic of these tumors. Treatment includes surgery, chemotherapy, and radiotherapy. Prognosis is poor despite of an aggressive therapy. We report one case of an atypical teratoid/rhabdoid tumor in a young child. She is an 18 month-old-girl who presented with central type facial palsy. After extensive surgery she improved transiently but relapsed immediately. Her condition was not permitted to receive radiotherapy or chemotherapy. Thereafter, with phrenic nerve palsy, she suffered from recurrent episodes of pneumonia and respiratory difficulties. Finaly, she was expired three months after the diagnosis and treatment.
Actins ; Central Nervous System ; Cerebellum* ; Child ; Diagnosis ; Drug Therapy ; Facial Paralysis ; Humans ; Infant ; Molecular Biology ; Mucin-1 ; Muscle, Smooth ; Paralysis ; Phrenic Nerve ; Pneumonia ; Prognosis ; Radiotherapy ; Vimentin

BACKGROUND AND OBJECTIVES: Tuberculous otitis media is not commonly found nowadays, and therefore, the index of suspicion is often low. However, once contracted, it can cause significant morbidities, such as profound hearing loss, labyrinthitis, facial nerve palsy and so on, if early diagnosis and treatment are not performed. MATERIALS AND METHODS: In the chronic otitis media patients who visited Masan Samsung Hospital from Jan. 1993 to Jan. 1996, 37 cases of pathologically proven tuberculous otitis media were retrospectively reviewed. And temporal bone computerized tomography (TBCT) of 14 cases of tuberculous otitis media were compared to those of chronic suppurative otitis media and choronic otitis media with cholesteatoma. RESULTS: 1) Classic clinical findings of the disease such as multiple perforation, painless otorrhea, young age are not consistent with the clinical findings reviewed here. 2) Unexpectedly severe hearing loss, facial paralysis, eroded malleus handle, polypoid granulation or necrotic debris in middle ear cavity were significant clinical features. 3) In TBCT findings, soft tissue density in the entire middle ear cavity, soft tissue density extension to superior external auditory canal, poor sclerotic change of mastoid air cell were more common than other types of chronic otitis media. 4) Most of cases were confirmed by operative specimen pathologically. 5) Delayed healing of postoperative wound and formation of granulation tissue suggested tuberculous otitis media. 6) Antituberculous chemotherapy provided effective means of treatment. CONCLUSION: Early diagnosis by pathologic examination of biopsied tissue obtained at OPD was mandatory to avoid complication and postoperative morbidity. Postoperative specimen obtained from middle ear surgery must be confirmed pathologically.
Cholesteatoma ; Cytochrome P-450 CYP1A1 ; Drug Therapy ; Ear Canal ; Ear, Inner ; Ear, Middle ; Early Diagnosis ; Facial Nerve ; Facial Paralysis ; Granulation Tissue ; Hearing Loss ; Humans ; Labyrinthitis ; Malleus ; Mastoid ; Otitis Media* ; Otitis Media, Suppurative ; Otitis* ; Paralysis ; Retrospective Studies ; Temporal Bone ; Wounds and Injuries

OBJECTIVETo compare different therapeutic effects between single usage of acupoints of Shaoyang meridian and the routine ones for treatment of Bell palsy in acute stage.

METHODSOne hundred and twenty cases with Bell palsy during the first three days were random divided into an observation group and a control group, 60 cases in each group. In observation group, acupoints of Shaoyang meridians were used from the 3rd day till the 14th day, Fengchi (GB 20), Yifeng (TE 17), Wangu (GB 12) at the affected side etc. were selected, after the 15th day, the routine acupoints were applied, Hegu (LI 4) on both sides, Fengchi (GB 20), Quchi (LI 11), Yangbai (GB 14) at the affected side etc. were selected; the control group were treated with the same acupoints as the routine ones in observation group since the 3rd day. And both two groups were treated with oral administration of Prednisone. House-Brackmann (H-B) functional grading of facial nerve on the 3rd day with the one of the 60th day as well as electroneurography (ENoG) on the 3rd day with the one of the 14th day were compared respectively.

RESULTSThe H-B grading improvement and cured rate were 95.0% (57/60) in observation group, which were suprior to 83.3% (50/60) in control group; the cured time in observation group was (34.21 +/- 8.026) days, significantly shorter than (42.78 +/- 9.029) days in control group (P < 0.05).

CONCLUSIONOn the basis of oral administration of Prednisone, single usage of acupoints of Shaoyang meridian in acute stage can make great improvement for recovery of Bell palsy, better than routine point selection.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Electromyography ; Facial Nerve ; physiopathology ; Facial Paralysis ; drug therapy ; physiopathology ; therapy ; Female ; Humans ; Male ; Meridians ; Middle Aged ; Prednisone ; therapeutic use ; Young Adult

Toxoplasmic encephalitis (TE) is the most common cause of opportunistic central nervous system infection in advanced acquired immunodeficiency syndrome (AIDS) patients. The incidence of TE has fallen markedly after the availability of highly active antiretroviral therapy and cotrimoxazole chemoprophylaxis. TE linked to AIDS is a rare entity in Korea, but we must consider TE in the differential diagnosis of the opportunistic infections in AIDS patients. We report a case of toxoplasmic encephalitis in an advanced AIDS patient presenting as progressive right facial palsy.
Acquired Immunodeficiency Syndrome ; Antiretroviral Therapy, Highly Active ; Central Nervous System Infections ; Chemoprevention ; Diagnosis, Differential ; Encephalitis* ; Facial Paralysis ; Humans ; Incidence ; Korea ; Opportunistic Infections ; Trimethoprim, Sulfamethoxazole Drug Combination

Acupuncture Points ; Administration, Cutaneous ; Adult ; Aged ; Drugs, Chinese Herbal ; administration & dosage ; Facial Paralysis ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult