안와하벽골절정복술 후 얼굴피부감각 변화에 관한 연구

성영제(Young je Sung),이병준(Byeong Jun Lee),유혜린(He len Lew) 대한안과학회 2017 대한안과학회지 Vol.58 No.4

목적: 단순 안와하벽골절 환자의 안와골절정복술 전후 얼굴의 안와아래신경 지배영역 감각 변화가 발생하는 데 영향을 주는 요인과 임상양상에 대해 알아보고자 하였다. 대상과 방법: 2001년 3월부터 2016년 3월까지 본원에서 안와하벽골절정복술을 시행 받은 171명의 의무기록을 후향적으로 조사하였다. 수상기전, 골절양상, 수상 후 수술까지의 기간, 골절크기, 삽입물 종류, 삽입물 두께를 분석하였다. 수술 전과 수술 후 6주에 전산화단층촬영을 시행하였고, 비수상안에서 안와아래신경관 길이와 각도를 측정하고 수술 후 1일, 1주, 6주, 6개월에 경과관찰 중 안와아래신경 지배 피부의 감각변화 유무와 관련된 임상적 특징을 조사하였다. 결과: 연령은 평균 30.4세, 남자 130명, 여자 41명이었고 수상 후 평균 9.5일에 정복술을 시행하였다. 감각이상은 술 전 9.9%, 술 후 1일에 38%였고, 6주에 13.5%로 회복되었으며, 6개월 이상 감각이상이 지속된 경우는 5.8%였다. 감각이상의 지속기간은 평균 20.5주였으며 안와아래 신경관의 길이가 짧을수록 6개월 이상 지속되는 감각저하가 나타나는 경향을 보였다. 결론: 안와하벽골절에서 발생하는 피부감각이상은 대부분 술 후 1주까지 나타나지만, 이후 지속되는 경우는 대략 20.5주가량 나타나다가 대부분의 경우 6개월 이내에 완전히 회복된다. 본 연구는 환자의 경과를 예측하는 데 도움이 될 것으로 사료되며, 따라서 수술 전 얼굴피부감각변화에 대하여 환자에게 충분히 설명이 필요하다. Purpose: To report the incidence of infraorbital nerve hypesthesia after inferior orbital wall fracture and reconstruction surgery and analyze the duration and factors to influence the occurence of the infraorbital nerve hypesthesia. Methods: From March, 2001 to March, 2016, the medical records of 171 patients with isolated orbital floor fracture reconstructed with porous polyethylene or titanium mesh was analyzed retrospectively. Injury mechanism, fracture type, time interval to surgery, fracture size, type and thickness of implant were analyzed. Orbit computed tomography scan was performed at preoperative and postoperative 6 weeks. Results: Mean age was 30.4 years (male:female = 130:41). The mean time interval to surgery was 9.5 days. Incidence of infraorbital hypesthesia was 9.9% preoperatively, 38% in a week of surgery, 13.5% in 6 weeks and 5.8% in 6 months. Infraorbital hypesthesia lasts 20.5 weeks and the length of infraorbital canal was the only risk factor of persistent infraorbital hypesthesia. Conclusions: Postoperative infraorbital nerve hypesthesia presents in a week in most patients. It last about 20.5 weeks, then mostly recovers in 6 months. This study will be useful to predict the clinical course of the patients with infraorbital nerve hypesthesia. Therefore, full explanation about the facial sense change is necessary for the patients with inferior orbital wall fracture.

콘택트렌즈 합병증으로 생긴 각막신생혈관과 각막지각감퇴

신영주,문준웅,위원량,Young Joo Shin,Joon Woong Moon,Won Ryang Wee 대한안과학회 2006 대한안과학회지 Vol.47 No.1

Purpose: To investigate the relationship between corneal neovascularization (CNV), corneal hypesthesia and dry eye syndrome. Methods: From July 2003 to November 2004, patients who had history of weraing soft contact lenses were selected and administered the Schirmer test; those with conjunctival inflammation and corneal complications were tested using an esthesiometer, and were given a dry eye questionnaire. Results: A longer period of soft contact lens wear was related to CNV and corneal hypesthesia (p<0.01), and theses two complications showed a significan relationship with symptoms of dry eye syndrome (p<0.01). Conclusions: Corneal neovascularization and corneal hypesthesia should be considered in cases of long term wear of soft contact lenses. The eyes with CNV and corneal hypesthesia had more severe symptoms of dry eye syndrome.

대칭적인 사지의 근력약화와 감각장애를 보인 비전신성 혈관염성 신경병 -증례보고-

이지형,김기찬,정호중,심영주,황기훈,김병훈 대한근전도전기진단의학회 2009 대한근전도 전기진단의학회지 Vol.11 No.2

Non-systemic vasculitic neuropathy is an arteriolar necrotizing vasculitis, histologically restricted to the peripheral nervous system. We report a case of a patient who had non-systemic vasculitic peripheral neuropathy that were presented muscle weakness, hypesthesia and peripheral edema. A 24 years old patient was admitted for sensory change and muscle weakness gradually aggravated and accompanied with painful edema of hand and foot, bilaterally. Physical examination revealed glove-stocking type hypesthesia in upper and lower limbs and the motor power of hands and feet was decreased to fair and good grade on manual muscle test. Apart from slight elevation of ESR and CRP, others were non-specific in hematologic test. Motor-sensory axonal loss type of peripheral polyneuropathy was detected in electrodiagnostic test. In neurohistologic test, chronic inflammatory neuropathy was found along with vasculitic change in arteriole, so patient was diagnosed as non-systemic vasculitic peripheral neuropathy.

하치조신경 마취 후 전기치수검사기(Electric pulp tester)를 이용한 하순부 감각 변화 평가

구명숙(Myong-Suk Ku),김진욱(Jin Wook Kim),전영훈(Young Hoon Jeon),권대근(Tae Geon Kwon),이상한(Sang Han Lee) 대한구강악안면외과학회 2011 대한구강악안면외과학회지 Vol.37 No.6

Introduction: As dental implant surgery is becoming increasingly popular, it has become one of the causes for the hypesthesia of the inferior alveolar nerve, along with other surgical procedures, such as a third molar extraction. In addition, it tends to cause legal problems between the operator and patient. Therefore, there must be a proper method that is reliable, objective and economical to assess the nerve impairment. For this reason, an attempt was made to use an Electric Pulp Tester to assess inferior alveolar nerve block anesthesia. Materials and Methods: Thirty patients were tested. Electric pulp testing of the lower jaw skin was performed at the three different times, before anesthesia, at the onset of sensory changes and after 15 minutes waiting from the onset, and on the 10 points of the chin, which produced 10 sections on the skin area. Results: Twenty seven patients (90%) could feel the electric stimulus on the chin at all 10 points before local anesthesia and the scores represent the statistical differences between the right and left points except R4 and L4. After anesthesia, the difference between the right and left points (L3-R3, L4-R4, L5-R5) increased significantly with time but two points (L2, R2) showed no significant difference. The scores on the left chin (L3, L4, L5) increased, whereas the other points (R1-R5, L1, L2) showed no significant differences. Conclusion: This study highlights the potential clinical use of an electric pulp tester for an assessment of inferior alveolar nerve impairment.

소아(小兒) Guillain-Barre 증후군(症候群) 치험례(治驗例) 보고(報告)

이재원,구은정,Lee, Jae-Won,Koo, Eun-Jeong 대한한의학회 1997 대한한의학회지 Vol.18 No.2

The writers have treated in hospital a two-year and 4 month boy child with Guillain-Barre syndrome whose chief complaints are flaccid tetraparalysis and hypesthesia for about three months from December 2, 1996. In the early stage, the principles and methods of treatment such as wind expelling and removal of dampness(?風濕) and obstruction in meridians and collaterals(通經活絡) were used and in the late stage the principles and methods of treatment to invigorate the spleen, replenish Ki(健脾益氣), and nourish the liver and kidneys(滋補肝腎) were applied, together with acupuncture, indirect moxibustion and massotheraphy. Since then, the symptom has gradually improved. Six months after onset, the boy child was recovered to a nearly normal condition. Therefore, this case of treatment is reported, together with consideration of literature.

Complex Korean Medicine Treatment after Elbow Replantation Following Traumatic Amputation: A Case Report

Eunbyul Cho,Shin-Hyeok Park,Hyesoo Jeon,Nam Geun Cho 대한침구의학회 2023 대한침구의학회지 Vol.40 No.1

Very few studies have been reported on upper extremity replantation following traumatic amputation. This case study aimed to report the progress of a patient treated with complex Korean medicine for 1 year after elbow replantation. The patient mainly complained of forearm sensory loss, muscle weakness, and hand pain after undergoing upper limb amputation and emergency replantation. He was hospitalized for approximately 50 days and then received outpatient treatment for approximately 10 months, followed by electroacupuncture, moxibustion, Chuna, herbal medicine, and transcutaneous electrical nerve stimulation. The muscle strength of the wrist joint improved to good (flexion) and fair (extension), and the forearm sensation was partially recovered approximately 10 months after the onset. To our knowledge, this is the first case report on replantation rehabilitation in Korean medicine, and it suggests that complex Korean medicine treatment might be beneficial for patients undergoing replantation after upper extremity amputation.

Toothache Caused by Sialolithiasis of the Submandibular Gland

Kim, Jae-Jeong,Lee, Hee Jin,Kim, Young-Gun,Kwon, Jeong-Seung,Choi, Jong-Hoon,Ahn, Hyung-Joon Korean Academy of Orofacial Pain and Oral Medicine 2018 Journal of Oral Medicine and Pain Vol.43 No.3

Sialolithiasis is the most frequent disease of the salivary glands, causing swelling and/or pain of the affected site. We report a 44-year-old woman who presented with severe pain in the lower left second molar region without swelling. Sialoliths on her left submandibular gland were confirmed by radiographic examinations. After robot-assisted sialoadenectomy, the pain did not recur but remained facial paralysis and unaesthetic scar.

Toothache Caused by Sialolithiasis of the Submandibular Gland

김재정,이희진,김영군,권정승,최종훈,안형준 대한안면통증∙구강내과학회 2018 Journal of Oral Medicine and Pain Vol.43 No.3

Sialolithiasis is the most frequent disease of the salivary glands, causing swelling and/or pain of the affected site. We report a 44-year-old woman who presented with severe pain in the lower left second molar region without swelling. Sialoliths on her left submandibular gland were confirmed by radiographic examinations. After robot-assisted sialoadenectomy, the pain did not recur but remained facial paralysis and unaesthetic scar.

Numb chin syndrome with metastatic malignancy in hyperparathyroidism: Case report

( Byung-yoon Roh ),( Jong-mo Ahn ),( Jin-soo Kim ),( Yo-seob Seo ) 조선대학교 구강생물학연구소 2017 Oral Biology Research (Oral Biol Res) Vol.41 No.3

Numb chin syndrome (NCS) is sensory neuropathy characterized by numbness in the chin and lower lip, involving distribution of the mental nerve. Causes of NCS may be of regional origin, a systemic disease, and malignancy. In this study, we report a case of NCS occurring as a first symptom of malignant metastasis in a 57-year-old female patient diagnosed with hyperparathyroidism.

The Measurement of the Sensory Recovery Period in Zygoma and Blow-Out Fractures with Neurometer Current Perception Threshold

Oh, Daemyung,Yun, Taebin,Kim, Junhyung,Choi, Jaehoon,Jeong, Woonhyeok,Chu, Hojun,Lee, Soyoung Korean Society of Plastic and Reconstructive Surge 2016 Archives of Plastic Surgery Vol.43 No.5

Background Facial hypoesthesia is one of the most troublesome complaints in the management of facial bone fractures. However, there is a lack of literature on facial sensory recovery after facial trauma. The purpose of this study was to evaluate the facial sensory recovery period for facial bone fractures using Neurometer. Methods Sixty-three patients who underwent open reduction of zygomatic and blowout fractures between December 2013 and July 2015 were included in the study. The facial sensory status of the patients was repeatedly examined preoperatively and postoperatively by Neurometer current perception threshold (CPT) until the results were normalized. Results Among the 63 subjects, 30 patients had normal Neurometer results preoperatively and postoperatively. According to fracture types, 17 patients with blowout fracture had a median recovery period of 0.25 months. Twelve patients with zygomatic fracture had a median recovery period of 1.00 month. Four patients with both fracture types had a median recovery period of 0.625 months. The median recovery period of all 33 patients was 0.25 months. There was no statistically significant difference in the sensory recovery period between types and subgroups of zygomatic and blowout fractures. In addition, there was no statistically significant difference in the sensory recovery period according to Neurometer results and the patients' own subjective reports. Conclusions Neurometer CPT is effective for evaluating and comparing preoperative and postoperative facial sensory status and evaluating the sensory recovery period in facial bone fracture patients.