ISSN : 0376-4672
말초안면신경마비는 가장 흔한 뇌신경 질환 중 하나이다. 말초안면신경마비의 병인은 외상, 감염, 특발성원인 등으로 다양하며, 드문 경우로 발치를 포함한 치과치료 중에 말초안면신경마비가 일어날 수 있다. 증상의 발생시점과 지속기간에 따라 안면마비는 즉시형과 지연형으로 나눌 수 있으며 즉시형의 경우 좀 더 흔하게 발생하며 대개 국소마취제의 주입과 관련이 있다. 그러나 안면마비의 발생시점과 증상이 지연되는 경우 병인론을 파악하는 것은 더욱 어렵다. 본 증례는 발치 후 발생한 지연형 안면신경 마비에 대한 소개로서 환자의 경우 발치 후 5일 뒤에 증상이 발생하여 약 1달간 증상이 지속되었다. 국내에서는 매우 드문 일로 증례보고와 함께 관련 문헌을 고찰하고자 한다.
Peripheral facial nerve palsy is one of the most common cranial nerve disease. There can be multiple etiologies including trauma, infection, idiopathic conditions. In rare case, during dental treatment including extraction, peripheral facial palsy also can occur. Based on the time of onset and duration of the symptom, facial palsy could be classified on immediate or delayed. Immediate facial palsy is relatively common and mainly associated with the injection of local anesthetic. However, in case that onset of facial palsy and symptom are delayed, it is difficult to determine the pathogenesis. We report a rare case of delayed facial palsy as a complication of tooth extraction, which occurred 5 days after the tooth extraction and subsided in about 1 month and discuss the possible etiology and management.
1. Garro A, Nigrovic LE. Managing peripheral facial palsy. Annals of emergency medicine. 2018;71(5):618-24.
2. Vasconcelos BC, Bessa-Nogueira RV, Maurette PE, Carneiro SC. Facial nerve paralysis after impacted lower third molar surgery: a literature review and case report. Med Oral Patol Oral Cir Bucal. 2006;11(2):E175-8.
3. Reitzen SD, Babb JS, Lalwani AK. Significance and reliability of the House-Brackmann grading system for regional facial nerve function. Otolaryngology—Head and Neck Surgery. 2009;140(2):154-8.
4. Steenen SA, Dubois L, Saeed P, de Lange J. Ophthalmologic complications after intraoral local anesthesia: case report and review of literature. Oral surgery, oral medicine, oral pathology and oral radiology. 2012;113(6):e1-e5.
5. Park CE, Choi MS, Chung DH, Byun JY. A Case of Facial Palsy Following Tooth Extraction. Korean J Otorhinolaryngol-Head Neck Surg. 2009;52(11):924-7.
6. Chisci G, Chisci C, Chisci V, Chisci E. Ocular complications after posterior superior alveolar nerve block: a case of trochlear nerve palsy. International journal of oral and maxillofacial surgery. 2013;42(12):1562-5.
7. Chevalier V, Arbab-Chirani R, Tea S, Roux M. Facial palsy after inferior alveolar nerve block: case report and review of the literature. International journal of oral and maxillofacial surgery. 2010;39(11):1139-42.
8. Shuaib A, Lee MA. Recurrent peripheral facial nerve palsy after dental procedures. Oral surgery, oral medicine, oral pathology. 1990;70(6):738-40.
9. Zalagh M, Boukhari A, Attifi H, Hmidi M, Messary A. Contralateral facial nerve palsy following mandibular second molar removal: is there co-relation or just coincidence? The Pan African Medical Journal. 2014;18.
10. Furuta Y, Ohtani F, Kawabata H, Fukuda S, Bergström T. High prevalence of varicella-zoster virus reactivation in herpes simplex virus-seronegative patients with acute peripheral facial palsy. Clinical infectious diseases. 2000;30(3):529-33.
11. Al-Muharraqi M, O'Sullivan E. Unilateral facial nerve paralysis following an infected lower third molar. International journal of oral and maxillofacial surgery. 2010;39(2):192-5.
12. Ling K. Peripheral facial nerve paralysis after local dental anesthesia. Oral surgery, oral medicine, oral pathology. 1985;60(1):23-4.
13. Tazi M, Soichot P, Perrin D. Facial palsy following dental extraction:report of 2 cases. Journal of oral and maxillofacial surgery. 2003;61(7):840-4.
14. Holland NJ, Weiner GM. Recent developments in Bell's palsy. Bmj. 2004;329(7465):553-7.
15. Adour KK, Ruboyianes JM, Trent CS, Von Doersten PG, Quesenberry Jr CP, Byl FM, et al. Bell's palsy treatment with acyclovir and prednisone compared with prednisone alone: a double-blind, randomized, controlled trial. Annals of Otology, Rhinology & Laryngology. 1996;105(5):371-8.
16. Furuta Y, Ohtani F, Chida E, Mesuda Y, Fukuda S, Inuyama Y. Herpes simplex virus type 1 reactivation and antiviral therapy in patients with acute peripheral facial palsy. Auris Nasus Larynx. 2001;28:S13-S7.
