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PART 1 Basic sciences of facial nerve
CHAPTER 1
Anatomy of facial nerve 1
I. 서론 ··········································································· 1
II. 본론 ·········································································· 1
두개 내 안면신경 ··················································· 1
측두골 내의 안면신경 ············································· 2
측두골 외의 안면신경 ············································· 5
안면신경의 혈액 공급 ············································· 7
III. 결론 ········································································· 7
CHAPTER 2
Physiology of facial nerve 9
I. 구조적 단위 ······························································· 9
II. 안면신경의 손상 ······················································· 9
III. 신경 손상 후 변성과 재생 ······································· 11
신경 변성 ···························································11
신경재생 ····························································12
근육의 탈신경, 재신경 지배 및 재생 ···························12
IV. 생리학적 손상 및 회복의 측정 ································ 13
V. 신경재생의 생리학 ················································· 13
VI. 연합운동 ······························································· 13
CHAPTER 3
Anatomy of facial muscles 15
I. 서론 ········································································· 15
II. 본론 ········································································ 15
발생 ··································································15
얼굴널힘줄계통 ····················································15
안면 유지 인대 ·····················································15
안면근육계 ··························································17
안면신경 손상을 예방하기 위한 접근법 ·······················24
목가지 ·······························································25
III. 결론 ······································································· 26
CHAPTER 4
Facial nerve grading system 27
I. 서론 ········································································· 27
II. 본론 ········································································ 28
House-Brackmann grading scale ····························· 28
Facial nerve grading scale 2.0 (revised House-Brakmann
grading scale) ···················································· 29
Sunny-brook facial grading scale ·····························29
Yanagihara grading scale ·······································29
eFACE ·······························································30
기타 ··································································30
III. 결론 ······································································· 30
CHAPTER 5
Electrophysiological measurement
of facial nerve function 31
I. 서론 ········································································· 31
II. 본론 ········································································ 31
신경흥분성 검사 ···················································32
최대자극 검사 ······················································32
신경전도 검사 ······················································32
근전도 검사 ·························································33
III. 결론 ······································································· 34
CHAPTER 6
Imaging study of
facial nerve disease 37
I. 서론 ········································································· 37
II. 본론 ········································································ 37
영상검사 ····························································37
영상해부학 ··························································37
안면신경의 정상 MR 소견 ·······································40
안면신경질환의 영상소견 ········································42
III. 결론 ······································································· 46
PART 2 Diseases of the facial nerve
CHAPTER 7
Facial nerve disease in
newborn and children 49
I. 신생아와 소아의 안면마비 ······································· 49
II. 선천성 안면마비 ····················································· 50
출생외상 ····························································50
Mobius 증후군 ·····················································52
Congenital unilateral lower lip paralysis ····················53
Melkersson-Rosenthal 증후군 ·································53
Goldenhar 증후군 ················································54
III. 후천성 안면마비 ···················································· 54
소아 벨마비 ·························································54
급성 중이염 ·························································55
라임병 ·······························································55
종양 ··································································55
측두골 골절 ·························································56
CHAPTER 8
Bell's palsy 61
I. 원인 ········································································· 62
바이러스성 원인 ···················································62
허혈 ··································································63
자가면역 손상 ······················································64
II. 벨마비의 발생 기전 ················································· 64
III. 치료 ······································································· 64
눈관리 ·······························································64
약물요법 ····························································65
CHAPTER 9
Herpes zoster oticus 71
I. 서론 ········································································· 71
II. 본론 ········································································ 71
정의 ·································································71
발병빈도 ····························································71
임상 양상 ···························································72
소아 HZO ··························································73
진단 ··································································73
치료 ··································································74
예후 ··································································75
III. 결론 ······································································· 75
CHAPTER 10
Facial weakness as a complication
of otologic disease 77
I. 서론 ········································································· 77
II. 염증성 원인에 의한 안면신경마비 ··························· 77
급성 중이염에 의한 안면신경마비 ·····························77
만성 중이염에 의한 안면신경마비 ·····························78
악성 외이도염에 의한 안면신경마비 ···························81
III. 종양에 의한 안면신경마비 ······································ 81
양성 종양 ···························································81
악성 종양 ···························································82
전이성 종양 ·························································82
IV. 결론 ······································································· 82
CHAPTER 11
Trauma of the facial nerve 85
I. 서론 ········································································· 85
II. 본론 ········································································ 85
외상성 안면마비의 원인 ··········································85
의인성 안면신경마비 ·············································85
측두골내 안면신경 손상 ··········································86
평가 및 진단 ························································86
치료 ··································································87
III. 결론 ······································································· 88
CHAPTER 12
Primary tumor of the facial nerve 91
I. 서론 ········································································· 91
II. 안면신경초종 ·························································· 91
안면신경초종의 증상 ·············································91
안면신경초종의 진단 ·············································92
안면신경초종의 치료 ·············································92
III. 슬신경절 혈관종 ···················································· 95
IV. 안면신경 사구체 종양 ············································ 95
CHAPTER 13
Extratemporal causes of
facial nerve paralysis 99
I. 서론 ········································································· 99
II. 본론 ········································································ 99
이하선 종양에서 안면신경 침범 ································99
이하선 종양의 수술 시 안면신경의 처치 ···················· 100
이하선 수술 중 안면신경 손상의 예방························ 100
수술 중 안면신경의 제거와 재건 ····························· 101
III. 결론 ····································································· 103
CHAPTER 14
Hemifacial spasm 105
I. 정의 ······································································· 105
II. 증상 ······································································ 105
III. 역학 ····································································· 105
IV. 원인 ····································································· 105
V. 병태생리 ······························································· 107
VI. 진단 ···································································· 107
VII. 치료 ··································································· 108
내과적 치료 ······················································ 108
외과적 치료 ······················································ 108
VIII. 합병증 ······························································· 110
IX. 예후 ···································································· 111
PART 3 Treatment of facial nerve paralysis
CHAPTER 15
Monitoring for surgical treatment 113
I. 서론 ····································································· 113
역사 ······························································· 113
적응증 ···························································· 113
II. 본론 ······································································ 113
신경 생리학적 방법 ············································ 113
술중 감시 ························································ 117
III. 결론 ····································································· 118
CHAPTER 16
Surgical indication for facial paralysis 121
I. 서론 ······································································· 121
II. 본론 ······································································ 123
내인적 원인에 의한 마비 ······································ 123
외인적 요인에 의한 안면마비 ································ 125
III. 결론 ····································································· 126
CHAPTER 17
Facial nerve decompression 129
I. 서론 ······································································· 129
II. 본론 ······································································ 129
안면신경 감압술의 이론적 배경 ····························· 129
안면신경 감압술의 적응증 및 시기 ························ 129
안면신경 감압술의 부위 ······································· 130
안면신경 감압술의 방법 ······································· 130
안면신경 감압술에 대한 반론 ································· 135
III. 결론 ····································································· 136
CHAPTER 18
Facial nerve management in skull base surgery 137
I. 서론 ······································································· 137
II. 안면신경 수술의 원칙 ··········································· 137
III. 안면신경의 전위 ·················································· 137
IV. 두개저 수술 시 안면신경의 조작 ·························· 138
중두개와 접근법 ················································ 138
경미로 접근법 ··················································· 139
경이 접근법 ······················································ 140
경와우 접근법 ··················································· 140
측두하와 접근법 ················································ 142
V. 안면신경 재건술 ··················································· 143
VI. 결론 ···································································· 143
CHAPTER 19
Nerve repair and nerve
substitution technique 145
I. 서론 ······································································· 145
II. 본론 ······································································ 145
직접 신경 문합술 ··············································· 145
신경 이식술 ······················································ 146
신경 전위술 ······················································ 148
증례 ······························································· 150
III. 결론 ····································································· 150
CHAPTER 20
Facial palsy; Surgical reconstruction 155
I. 서론 ······································································· 155
II. 수술 전 검사 및 관리 ············································ 155
수술 전 검사 ····················································· 155
수술 전 관리 ····················································· 156
III. 수술적 치료법 ······················································ 156
정적 재건술 ······················································ 156
동적 재건술 ······················································ 158
IV. 합병증, 술 후 경과 및 결과 ································· 162
V. 결론 ······································································ 163
CHAPTER 21
Facial rejuvenation for facial palsy 165
I. 서론 ······································································· 165
II. 본론 ······································································ 166
III. 결론 ····································································· 171
CHAPTER 22
Physical therapy and neuromuscular retraining 173
I. 서론 ······································································· 173
II. 본론 ······································································ 173
안면근육의 특징 ················································ 173
물리치료의 적응 ················································ 173
고전적 물리치료 ················································ 174
신경근 재훈련 ··················································· 174
신경근 재훈련 기법 ············································ 177
III. 결론 ····································································· 178
CHAPTER 23
Future treatment modalities 181
I. 서론 ······································································· 181
II. 본론 ······································································ 181
이상적인 신경유도도관으로서 갖추어야 할 특성 ········ 181
III. 신경유도도관의 성분에 따른 종류 ························ 182
Natural material ··············································· 182
Natural polymer ··············································· 182
합성 polymer 신경유도도관 ·································· 183
IV. 신경재생을 촉진시키기 위한 방법 ························ 183
슈반세포의 이식 ················································ 183
생리활성물질의 주입 ········································· 183
줄기세포의 주입 ················································ 183
물리적 자극의 병합 ············································ 183
V. 결론 ······································································ 184
찾아보기 ································································ 187
CHAPTER 1
Anatomy of facial nerve 1
I. 서론 ··········································································· 1
II. 본론 ·········································································· 1
두개 내 안면신경 ··················································· 1
측두골 내의 안면신경 ············································· 2
측두골 외의 안면신경 ············································· 5
안면신경의 혈액 공급 ············································· 7
III. 결론 ········································································· 7
CHAPTER 2
Physiology of facial nerve 9
I. 구조적 단위 ······························································· 9
II. 안면신경의 손상 ······················································· 9
III. 신경 손상 후 변성과 재생 ······································· 11
신경 변성 ···························································11
신경재생 ····························································12
근육의 탈신경, 재신경 지배 및 재생 ···························12
IV. 생리학적 손상 및 회복의 측정 ································ 13
V. 신경재생의 생리학 ················································· 13
VI. 연합운동 ······························································· 13
CHAPTER 3
Anatomy of facial muscles 15
I. 서론 ········································································· 15
II. 본론 ········································································ 15
발생 ··································································15
얼굴널힘줄계통 ····················································15
안면 유지 인대 ·····················································15
안면근육계 ··························································17
안면신경 손상을 예방하기 위한 접근법 ·······················24
목가지 ·······························································25
III. 결론 ······································································· 26
CHAPTER 4
Facial nerve grading system 27
I. 서론 ········································································· 27
II. 본론 ········································································ 28
House-Brackmann grading scale ····························· 28
Facial nerve grading scale 2.0 (revised House-Brakmann
grading scale) ···················································· 29
Sunny-brook facial grading scale ·····························29
Yanagihara grading scale ·······································29
eFACE ·······························································30
기타 ··································································30
III. 결론 ······································································· 30
CHAPTER 5
Electrophysiological measurement
of facial nerve function 31
I. 서론 ········································································· 31
II. 본론 ········································································ 31
신경흥분성 검사 ···················································32
최대자극 검사 ······················································32
신경전도 검사 ······················································32
근전도 검사 ·························································33
III. 결론 ······································································· 34
CHAPTER 6
Imaging study of
facial nerve disease 37
I. 서론 ········································································· 37
II. 본론 ········································································ 37
영상검사 ····························································37
영상해부학 ··························································37
안면신경의 정상 MR 소견 ·······································40
안면신경질환의 영상소견 ········································42
III. 결론 ······································································· 46
PART 2 Diseases of the facial nerve
CHAPTER 7
Facial nerve disease in
newborn and children 49
I. 신생아와 소아의 안면마비 ······································· 49
II. 선천성 안면마비 ····················································· 50
출생외상 ····························································50
Mobius 증후군 ·····················································52
Congenital unilateral lower lip paralysis ····················53
Melkersson-Rosenthal 증후군 ·································53
Goldenhar 증후군 ················································54
III. 후천성 안면마비 ···················································· 54
소아 벨마비 ·························································54
급성 중이염 ·························································55
라임병 ·······························································55
종양 ··································································55
측두골 골절 ·························································56
CHAPTER 8
Bell's palsy 61
I. 원인 ········································································· 62
바이러스성 원인 ···················································62
허혈 ··································································63
자가면역 손상 ······················································64
II. 벨마비의 발생 기전 ················································· 64
III. 치료 ······································································· 64
눈관리 ·······························································64
약물요법 ····························································65
CHAPTER 9
Herpes zoster oticus 71
I. 서론 ········································································· 71
II. 본론 ········································································ 71
정의 ·································································71
발병빈도 ····························································71
임상 양상 ···························································72
소아 HZO ··························································73
진단 ··································································73
치료 ··································································74
예후 ··································································75
III. 결론 ······································································· 75
CHAPTER 10
Facial weakness as a complication
of otologic disease 77
I. 서론 ········································································· 77
II. 염증성 원인에 의한 안면신경마비 ··························· 77
급성 중이염에 의한 안면신경마비 ·····························77
만성 중이염에 의한 안면신경마비 ·····························78
악성 외이도염에 의한 안면신경마비 ···························81
III. 종양에 의한 안면신경마비 ······································ 81
양성 종양 ···························································81
악성 종양 ···························································82
전이성 종양 ·························································82
IV. 결론 ······································································· 82
CHAPTER 11
Trauma of the facial nerve 85
I. 서론 ········································································· 85
II. 본론 ········································································ 85
외상성 안면마비의 원인 ··········································85
의인성 안면신경마비 ·············································85
측두골내 안면신경 손상 ··········································86
평가 및 진단 ························································86
치료 ··································································87
III. 결론 ······································································· 88
CHAPTER 12
Primary tumor of the facial nerve 91
I. 서론 ········································································· 91
II. 안면신경초종 ·························································· 91
안면신경초종의 증상 ·············································91
안면신경초종의 진단 ·············································92
안면신경초종의 치료 ·············································92
III. 슬신경절 혈관종 ···················································· 95
IV. 안면신경 사구체 종양 ············································ 95
CHAPTER 13
Extratemporal causes of
facial nerve paralysis 99
I. 서론 ········································································· 99
II. 본론 ········································································ 99
이하선 종양에서 안면신경 침범 ································99
이하선 종양의 수술 시 안면신경의 처치 ···················· 100
이하선 수술 중 안면신경 손상의 예방························ 100
수술 중 안면신경의 제거와 재건 ····························· 101
III. 결론 ····································································· 103
CHAPTER 14
Hemifacial spasm 105
I. 정의 ······································································· 105
II. 증상 ······································································ 105
III. 역학 ····································································· 105
IV. 원인 ····································································· 105
V. 병태생리 ······························································· 107
VI. 진단 ···································································· 107
VII. 치료 ··································································· 108
내과적 치료 ······················································ 108
외과적 치료 ······················································ 108
VIII. 합병증 ······························································· 110
IX. 예후 ···································································· 111
PART 3 Treatment of facial nerve paralysis
CHAPTER 15
Monitoring for surgical treatment 113
I. 서론 ····································································· 113
역사 ······························································· 113
적응증 ···························································· 113
II. 본론 ······································································ 113
신경 생리학적 방법 ············································ 113
술중 감시 ························································ 117
III. 결론 ····································································· 118
CHAPTER 16
Surgical indication for facial paralysis 121
I. 서론 ······································································· 121
II. 본론 ······································································ 123
내인적 원인에 의한 마비 ······································ 123
외인적 요인에 의한 안면마비 ································ 125
III. 결론 ····································································· 126
CHAPTER 17
Facial nerve decompression 129
I. 서론 ······································································· 129
II. 본론 ······································································ 129
안면신경 감압술의 이론적 배경 ····························· 129
안면신경 감압술의 적응증 및 시기 ························ 129
안면신경 감압술의 부위 ······································· 130
안면신경 감압술의 방법 ······································· 130
안면신경 감압술에 대한 반론 ································· 135
III. 결론 ····································································· 136
CHAPTER 18
Facial nerve management in skull base surgery 137
I. 서론 ······································································· 137
II. 안면신경 수술의 원칙 ··········································· 137
III. 안면신경의 전위 ·················································· 137
IV. 두개저 수술 시 안면신경의 조작 ·························· 138
중두개와 접근법 ················································ 138
경미로 접근법 ··················································· 139
경이 접근법 ······················································ 140
경와우 접근법 ··················································· 140
측두하와 접근법 ················································ 142
V. 안면신경 재건술 ··················································· 143
VI. 결론 ···································································· 143
CHAPTER 19
Nerve repair and nerve
substitution technique 145
I. 서론 ······································································· 145
II. 본론 ······································································ 145
직접 신경 문합술 ··············································· 145
신경 이식술 ······················································ 146
신경 전위술 ······················································ 148
증례 ······························································· 150
III. 결론 ····································································· 150
CHAPTER 20
Facial palsy; Surgical reconstruction 155
I. 서론 ······································································· 155
II. 수술 전 검사 및 관리 ············································ 155
수술 전 검사 ····················································· 155
수술 전 관리 ····················································· 156
III. 수술적 치료법 ······················································ 156
정적 재건술 ······················································ 156
동적 재건술 ······················································ 158
IV. 합병증, 술 후 경과 및 결과 ································· 162
V. 결론 ······································································ 163
CHAPTER 21
Facial rejuvenation for facial palsy 165
I. 서론 ······································································· 165
II. 본론 ······································································ 166
III. 결론 ····································································· 171
CHAPTER 22
Physical therapy and neuromuscular retraining 173
I. 서론 ······································································· 173
II. 본론 ······································································ 173
안면근육의 특징 ················································ 173
물리치료의 적응 ················································ 173
고전적 물리치료 ················································ 174
신경근 재훈련 ··················································· 174
신경근 재훈련 기법 ············································ 177
III. 결론 ····································································· 178
CHAPTER 23
Future treatment modalities 181
I. 서론 ······································································· 181
II. 본론 ······································································ 181
이상적인 신경유도도관으로서 갖추어야 할 특성 ········ 181
III. 신경유도도관의 성분에 따른 종류 ························ 182
Natural material ··············································· 182
Natural polymer ··············································· 182
합성 polymer 신경유도도관 ·································· 183
IV. 신경재생을 촉진시키기 위한 방법 ························ 183
슈반세포의 이식 ················································ 183
생리활성물질의 주입 ········································· 183
줄기세포의 주입 ················································ 183
물리적 자극의 병합 ············································ 183
V. 결론 ······································································ 184
찾아보기 ································································ 187
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