• The Journal of Internal Korean Medicine
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• v.44 no.5
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• pp.929-940
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• 2023

Objectives: This study reports on the efficacy of Korean medicine treatments for peripheral facial nerve palsy and sleep disorders that occur after microvascular decompression. Methods: A 57-year-old female patient with right facial palsy was treated with herbal medicines and acupuncture for 36 days. The treatment effect was evaluated using the House Brackmann Grading System (HBGS), Yanagihara's Unweighed Grading System (Yanagihara's score), and the Korean Modified Leeds Sleep Evaluation Questionnaire (KMLSEQ). Results: Following treatment, the patient showed a decrease in HBGS and an improvement in Yanagihara's score and KMLSEQ score. Conclusions: Korean medicine treatments appeared to be effective in reducing facial nerve palsy. Further clinical research on patients with facial nerve palsy is needed.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.35 no.4
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• pp.163-171
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• 2022

Objectives : The aim of this study was to report that effect of Korean medicine treatment for patient with peripheral facial nerve palsy accompanied by hemifacial spasm through hospitalization. Methods : We treated a patient with facial nerve palsy by acupuncture, electroacupuncture, herbal medicine, pharmacopuncture and cupping. The effect of treatment was evaluated using the House-Brackmann scale, the Yanagihara grading system, and the visual analogue scale(VAS). Results : During the 18 days hospitalization period, the symptoms of hemifacial spasm disappeared and the facial palsy improved. The House-Brackmann scale changed from 4 grade to 2 grade, the Yanagihara grading system changed from 19 to 47, and the VAS changed from 3 to 0. Conclusions : This case report suggests that Korean medicine could be effective for facial palsy accompanied by hemifacial spasms.

• Annals of Clinical Neurophysiology
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• v.23 no.2
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• pp.121-125
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• 2021

Bell's palsy is an acute peripheral facial paralysis with no detectable cause. Although the prognosis of Bell's palsy is generally good, some patients experience poor recoveries and there is no established treatment for those that do not recover even after receiving the conventional treatment. Here we present two cases of refractory Bell's palsy with facial nerve enhancement in magnetic resonance imaging who showed symptomatic improvement after the late administration of high-dose intravenous methylprednisolone.

• Archives of Craniofacial Surgery
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• v.18 no.1
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• pp.65-70
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• 2017

A 25-years-old woman with mandibular prognathism underwent a mandibular setback by way of mandibular sagittal split ramus osteotomy (MSSRO). After 2 days of operation, she developed difficulty of closing her right eye. The blink reflex test and motor nerve conduction study of the right orbicularis oris muscle were revealed right facial neuropathy of unknown origin and House-Brackmann facial nerve grading system (HBFNGS) grade V. For treatment, we initially prescribed oral prednisolone and nimodipine including physical therapy. The samples consisted of 11 facial nerve palsy patients caused by MSSRO and were analysed about onset of facial nerve palsy, postoperative HBFNGS, final HBFNGS, treatment method and recovery time. At 10 weeks of treatment of nimodipine, she had completely regained normal function (HBFNGS grade I) of the right facial nerve. The clinical results lead to assume a fast recovery of facial nerve function by the nimodipine medication, whereas average time of recovery is 16.32 weeks in references. Despite of the limited one patient treated, the result was very promising with respect to a faster recovery of the facial nerve function. Considering the use of nimodipine treatment for peripheral facial nerve palsy following a surgical approach with an anatomically preserved nerve can be recommended.

• Journal of Korean Neurosurgical Society
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• v.30 no.4
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• pp.479-485
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• 2001

Objective : Several conservative treatments have been tried in peripheral facial nerve paralysis, because 80% of patients recover spontaneously. Surgical decompression may be helpful to the residual, medically intractable patients. We present here our experiences of facial nerve decompression via middle fossa approach, which seems to be one of good surgical therapeutic options for medically refractory peripheral facial nerve paralysis. Method : Three cases of medically intractable peripheral type facial paralysis were microscopically operated via middle cranial fossa approach to decompress the labyrinthine segment of the facial nerve and geniculate ganglion by searching landmarks of middle meningeal artery, greater superficial petrosal nerve and facial hiatus. Results : After operation, two cases of Bell's palsy improved substantially and one case of post-traumatic facial paralysis improved partially. Conclusion : This report is presented to describe the surgical facial nerve decompression via middle fossa for early control of peripheral type facial paralysis. Surgical decompression of edematous peripherally paralysed facial nerve could be preferred to conservative treatment in some patients although more surgical experience should be required.

• Journal of Acupuncture Research
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• v.40 no.4
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• pp.395-402
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• 2023

Bell's palsy is an acute facial paralysis caused by peripheral facial nerve dysfunction. The aim of this study is to assess the efficacy of Korean medicine in the treatment of three patients who were hospitalized and diagnosed with Bell's palsy within 2 weeks of coronavirus disease 2019 (COVID-19) infection. The patients were administered with Korean medicine treatments, steroids, and antiviral drugs. Moreover, the Korean medicine treatments include acupuncture, pharmacopuncture, moxibustion, physical therapy, and herbal medicine. Symptom improvement was evaluated daily using the Yanagihara facial nerve grading system, a facial function evaluation tool. Furthermore, it was suggested that the patients affected by Bell's palsy after COVID-19 infection may have a slower improvement in their treatment progress compared with those without COVID-19 infection in the acute stage.

• Journal of Haehwa Medicine
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• v.9 no.1
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• pp.243-258
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• 2000

From the reference research, the results obtained were as follows. 1. Until the "Song" dynasty, the predominant cause of facial nerve paralysis was the attack of Pathogenic Wind to "the Stomach Channel of Foot Yangming, (St.C.); and "the Small Intestine Channel of Hand Taiyang, (S.I.C.). They recognized the facial paralysis as an aspect of palsy. 2. In the period of Jin-Yuan(金元), the predominant cause was described as "Xuexu"(the deficiency of blood) and phlegm. They recognized that the facial palsy was a palsy. However, they also acceded to the possibility that there could be other explanations. 3. In the period of "Ming & Qing", there were numerous kinds of causes. For example, the following were identified as attacking the Meridian: the Pathogenic Cold; Pathogenic Heat; "Xinxu"(the deficiency in the heart); Fire and Heat combined as a pathogenic factor; "Pixu"(the deficiency in the spleen); and, "Xinxu"(the deficiency of blood). 4. In the past, Koreans have explained the facial paralysis according to the Chinese theories mentioned. However, recently there has been an emergence of another Chinese theory; whereby, facial paralysis is classified into causes and symptoms, and then medical treatment is applied accordingly. 5. From the occident medical perspective, the facial paralysis is categorized into two causes. The first is called central facial nerve paralysis and the second is called peripheral facial nerve paralysis. The latter is mainly caused by Bell's palsy, Herpez zoster oticus, and trauma.

• Journal of Acupuncture Research
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• v.30 no.5
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• pp.107-116
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• 2013

Objjectives : The purpose of this study is to investigate the correlation between surface electromyography(SEMG) and assessment scales for facial palsy. Methods : The subjects for this study were 21 patients who had peripheral facial nerve palsy. We analyzed about the correlation between the results of SEMG and facial nerve assessment scales that were carried out at the same time. The assessment scales used in this study were House-Brackmann scale, Yanagihara grading system, Sunnybrook facial grading system. Results : There are considerable correlation between the results of SEMG and the results of three kinds of assessment scales for facial nerve palsy. Conclusions : SEMG may be an objective examination for facial nerve palsy. Some research aimed at development of SEMG examination guideline for facial nerve palsy will be needed after this. And we expect that many researches for development of diagnostic equipments or treatment equipments that utilize SEMG will proceed.

• Journal of Acupuncture Research
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• v.39 no.4
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• pp.297-303
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• 2022

Background: This retrospective study aimed to determine whether there were correlations between the number and type of accompanying symptoms of peripheral facial nerve palsy, and surface electromyography (SEMG) and clinical assessment scales to help diagnosis. Methods: There were 30, cases of peripheral facial nerve palsy at Visit 1 to the Korean Medicine Hospital, Dong-eui University, 22 cases at Visit 2 and 10 cases at Visit 3. The study period was from July 19, 2021 to November 31, 2021. Symptoms were evaluated three times (with two-week intervals which began 7 days from onset) using SEMG, clinical assessment scales and accompanying symptoms. In this study, the House-Brackmann grading system (HBGS), and the Yanagihara's unweighted grading system (Y-score) clinical assessment scales were used. The Pearson or Spearman correlation was used for statistical analysis. Results: On Visit 1, the number of accompanying symptoms of peripheral facial nerve palsy had no significant correlation with other measures. On Visits 1-3, the HBGS score had a significant negative correlation with the Y-score. On Visit 2, most of the mean values measured had significant correlations with each other although not between SEMG-Z and SEMG-O that Z means a zygomaticus muscle and O means a orbicularis oris muscle. On Visit 3, the number of accompanying symptoms significantly correlated with the clinical assessment scales. The HBGS score, Y-score, and SEMG measurements (except SEMG-Z) had significant correlations with each other. A significant positive correlation between SEMG-Z and SEMG-T was noted. Conclusion: We predict accompanying symptoms can be used to diagnose the peripheral facial nerve palsy including both clinical assessment scales and SEMG measurements at 2-5 weeks after onset.

• Archives of Craniofacial Surgery
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• v.25 no.1
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• pp.1-10
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• 2024

The facial nerve stimulates the muscles of facial expression and the parasympathetic nerves of the face. Consequently, facial nerve paralysis can lead to facial asymmetry, deformation, and functional impairment. Facial nerve palsy is most commonly idiopathic, as with Bell palsy, but it can also result from a tumor or trauma. In this article, we discuss traumatic facial nerve injury. To identify the cause of the injury, it is important to first determine its location. The location and extent of the damage inform the treatment method, with options including primary repair, nerve graft, cross-face nerve graft, nerve crossover, and muscle transfer. Intracranial proximal facial nerve injuries present a challenge to surgical approaches due to the complexity of the temporal bone. Surgical intervention in these cases requires a collaborative approach between neurosurgery and otolaryngology, and nerve repair or grafting is difficult. This article describes the treatment of peripheral facial nerve injury. Primary repair generally offers the best prognosis. If primary repair is not feasible within 6 months of injury, nerve grafting should be attempted, and if more than 12 months have elapsed, functional muscle transfer should be performed. If the affected nerve cannot be utilized at that time, the contralateral facial nerve, ipsilateral masseter nerve, or hypoglossal nerve can serve as the donor nerve. Other accompanying symptoms, such as lagophthalmos or midface ptosis, must also be considered for the successful treatment of facial nerve injury.