O-Jin Kwon, an otolaryngology specialist (Ping ENT Clinic) and Hidak are working together. [코/목/귀 상담소]. Hidak’s counselor will answer all your questions about nose, throat, and ear-related diseases.
It is known that broadcaster Choi Hee suffers from facial paralysis due to the aftereffects of herpes zoster. In the last 10 years, the number of patients with facial nerve palsy has increased by 42%. According to data from the Health Insurance Review and Assessment Service, the number of patients with facial nerve palsy increased from 63,128 in 2011 to 89,464 in 2020. In terms of age, as of 2020, those in their 50s and 60s accounted for 45.7% of all patients, but those in their 20s and younger accounted for 9.8%. Facial paralysis can have serious sequelae if not treated in time. Hidak Otolaryngology Consulting Doctor Oh-Jin Kwon (Ping ENT Clinic)explained in detail about the diseases that can cause facial nerve palsy and the treatment methods to prevent its sequelae.
Q. Where exactly is the facial nerve located?
The facial nerve is the 7th cranial nerve among the 12 cranial nerves. The facial nerve leaves the brain and travels along the facial neural tube in the temporal bone, the skull around the ear, through a passage made of bone called the inner ear canal located inside the ear, and is distributed to the muscles that move the face through the parotid gland, the salivary gland located under the ear. there is.
Q. What diseases can cause facial nerve palsy?
As the driving path of the facial nerve is mainly inside and around the ear, facial nerve palsy is often caused by ear disease. Otitis media, temporal bone fractures, tumors, and Ramsay-Hunt syndrome, which is herpes zoster, are the main ear-related diseases that cause facial nerve palsy.
In addition to these ear diseases, congenital paralysis, paralysis due to stroke and brain tumor, paralysis due to parotid gland tumor or surgical complications, etc. can be the cause. However, the most common cause of facial nerve palsy is idiopathic. In more than 50% of facial nerve palsy, the cause is unknown, and this type of palsy is called ‘Bell’s palsy’.
Q. After sleeping in a cold place, my mouth went back. Is this a type of facial nerve palsy?
People often say that if you sleep with your face in a cold place for a long time, your face will turn around. Turning the face also means facial nerve palsy. In fact, if you put your face in a cold place for a long time, blood circulation around the facial nerve may be impaired due to vasoconstriction, and if the facial nerve is compressed even by a hard place, paralysis may occur. Therefore, in the cold winter, it is necessary to be careful, such as not sleeping in a cold place after drinking too much.
Q. I can’t feel the taste well with facial paralysis. Could hypogassing also be a symptom of facial nerve palsy?
In case of facial nerve palsy, the facial expression of the paralyzed side disappears. The eyes do not close, which causes the eyes to become dry and red, causing the tail of the lips to droop and not move, causing saliva and food to flow into it. Because the facial nerve is responsible for not only the muscles of the face, but also part of the sense of taste, the taste in the front of the tongue may also deteriorate.
Q. Is there a way to tell if it is a stroke or a facial paralysis?
To tell the difference between stroke and facial paralysis, you can look at the forehead wrinkles. In the case of peripheral or Bell’s palsy caused by ear disease, the paralysis of the forehead muscle occurs together, but in the case of central, such as a stroke, paralysis of the forehead muscle does not occur. Because the facial nerve is responsible for not only the muscles of the face, but also part of the sense of taste, the taste in the front of the tongue may also deteriorate.
Q. Does facial nerve palsy recover on its own if the cause is resolved?
Treatment for facial nerve palsy depends on the cause. In the most common Bell’s palsy, about 60 to 70% are known to recover on their own, but in some cases the recovery is not complete.
If the cause can be identified, oral steroids are used together while treating the cause first. In case of otitis media, antibiotic treatment is concurrently performed, and in case of tumor, tumor excision is performed.
Q. The degree of paralysis is severe. How to treat this case?
If the degree of facial nerve palsy is very severe after a temporal bone fracture, Bell’s palsy, Ramsay-Hunt syndrome, etc., facial nerve decompression should be performed within 7 days of the onset to prevent facial nerve edema to improve the prognosis. If the facial nerve palsy does not recover despite these aggressive treatments, plastic surgery is sometimes performed to relieve discomfort, and Botox injections are sometimes used to reduce facial muscle spasms.
Q. Maybe I missed the golden hour? What can I do to prevent sequelae?
More than 90% of Bell’s palsy, the most common, recovers completely within 6 months. However, if the facial paralysis is caused by a specific cause other than Bell’s palsy, the prognosis is poor. First of all, it is important how quickly the causal disease is cured, but even if the causal disease is treated, the paralysis symptoms may not completely recover.
When facial nerve palsy occurs, it is necessary to immediately go to a hospital to find out whether there is a disease that may be the cause, and to treat the disease quickly, the rate of complete recovery increases. In order to prevent the sequelae of facial paralysis, treatment within 3 weeks after the onset of paralysis is of utmost importance. It is known that the recovery rate will increase and the sequelae will be less if you receive medication including steroids within 3 weeks, but there is no solid evidence yet.
Help = Hidak Consulting Doctor Ohjin Kwon
