• Journal of Acupuncture Research
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• v.18 no.1
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• pp.237-247
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• 2001

Background : infection associated with otalgia, herpetic eruptions, facial palsy, trigeminal pain and cochleovestibular dysfunction such as hearing dishubance, tinnitus, vertigo and other symptoms, and is not frequently encountered in otolaryngologic field. And facial paralysis occured by this syndrome is rapid in onset, usually severe in degree, and poor in prognosis. Objectives : To evaluate the Oriental Medicine's treatment and prognosis of Herpes zoster oticus and to classify of peripheral Facial palsy on Oriental Medicine. Methods : Clinical observation and analysis about a case of Ramsay-Hunt syndrome III type was done, who visited Dongguk University Gangnam Hospital. This case is managed by integrated therapy of oriental and western medicine. In oriental medicine, to treate ear pain, heonggae-yeongoetang(荊芥蓮翹湯) was given and to treat herpetic eruption, 8 constitution acupuncture treatement was done. In western medicine, antiviral agent, acyclovir and steroid hormone, prednisolon were treated. Result : About 6 weeks treatment, this case which has worse prognosis than Bell's palsy, was completed cured without any complication. Conclusion : 1. Futher divided classification about non-infectious and infectious facial palsy include "Ramsay Hunt Syndrome" is needed. 2. In acute state, Jeonyohwadan's (纏腰火丹) treatement can be applied, but the difference of invasion part, primary symptom such as ear pain and herpetic eruption is needed another treatment. 3. Ear pain and herpetic eruption can be treated in part of poongyeol(風熱) and subyeol(濕熱). 4. In Acupuncture treatement, Jeonyohwadan's (纏腰火丹) treatement can be applied in acute stage and guanwasa's treatement can be applied in chronic stage. but futher research is needed. 5. This case, Ramsay Hunt Syndrome IlI type, was managed by integrated therapy such as heonggae-yeongoetang(荊芥蓮翹湯), 8 constitution acupuncture treatement, acyclovir and prednisolon and this treatement was good effect.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.19 no.2
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• pp.192-201
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• 2006

Objectives : Recently, He-Ne laser has been used for clinical purpose. We study the medical basis of He-Ne laser therapy and We make a proposal concerning the clinical application of using He-Ne laser in Medicine. Methods : We have selected data related to He-Ne laser therapy and study how to use He-Ne laser in clinic. Results : In biology, He-Ne laser therapy has been effects of an improve in skin regeneration an improve in peripheral and central nerve regeneration an improve in muscle regeneration, an anti-inflammation an alleviation of pain and a bone repair. In oriental medicine, He-Ne laser has been used to laser acupuncture and laser oriental physical treatment. In clinic, He-Ne laser have been used to care several parts like as facial palsy, facial spasm, trigeminal neuropathy, rhinitis and tinnitus. Recently, there is argument that He-Ne laser therapy is suitable to medical insurance. Conclusions : Laser therapy in oriental medicine is widespread and We can apply He-Ne laser to facial palsy, facial spasm, trigeminal neuropathy, rhinitis, tinnitus by using laser acupuncture or laser oriental physical treatment. Till now the whole mechanisms are not fully understood, so we hope to study these mechanisms actively and make suitable to medical insurance device in the near future.

• Annals of Clinical Neurophysiology
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• v.4 no.1
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• pp.85-88
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• 2002

Ramsay-Hunt syndrome is a viral disease associated with peripheral facial nerve paralysis accompany by erythematous vesicular rashs on the ear(zoster oticus) or in the mouth. Based on clinical presentations that indicated involvement of more than one ganglion, the gasserian, geniculate, petrous, accessory, jugular and second and third dorsal root ganglia comprised a chain in which inflammation of a single ganglion could extend to nearby ganglia. A 71-year-old man presented with left. peripheral facial palsy with otalgia, vesicular eruption in $V_2$, $V_3$, C2, C3 dermatome, tinnitus, and hearing loss.

• Annals of Clinical Neurophysiology
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• v.3 no.1
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• pp.9-14
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• 2001

Background : Bell's palsy(BP) is defined as an idiopathic peripheral facial paralysis of acute onset, accounting for more than 50% of all cases of facial paralysis. Different theories on the etiology of BP have been proposed. Herpes simplex virus-1(HSV) has been the most suspicious causative agent, but varicella zoster virus(VZV) also is suspected. Objectives : We evaluated the serological changes of IgG and IgM titer of HSV and VZV to know the causative agent of BP. Materials and Methods : Subjects consisted of 35 patients who developed acute idiopathic unilateral facial palsy(16 men and 19 women from 9 to 78 years old) within a week of onset. We took the serum of the acute and convalescent stages, respectively. Serum IgG and IgM titer of HSV and VZV were measured in acute and convalescent stages by EIA method. Results : Only the HSV IgG titer showed statistically significant elevation in the convalescent stage(p=0.0291). Others did not show any significant change between the acute and convalescent stage. Conclusion : We concluded that HSV may be related to the causative agent of BP.

• Journal of Acupuncture Research
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• v.27 no.6
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• pp.77-84
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• 2010

Objectives : This study was to compare the incipient grade and improvement rate between each opposite gender and part on peripheral facial nerve paralysis. Methods : We investigated 64 cases of patient with peripheral facial nerve paralysis and divided into four groups with each gender and affected part and compared their incipient grade and rate of improvement. All groups were evaluated by Yanagihara's unweighted grading system before treatment and in everyday and after treatment. Results & Conclusion : 1. There's a difference of incipient grade between each opposite affected lesion in male. But there was not significant statistics. 2. There's no difference of incipient grade between each opposite affected lesion in female. 3. There's a difference of incipient grade between each opposite gender, affected their right side. But there was not significant statistics. Left side affecting palsy is more severe than right in male, and reversed results in female. But there were not significant statistics. There's no differences between each affected lesion in female. 4. There's no differences of improvement rate between each affected lesion in female. 5. The group, affected right side had better rate of improvement than another in male. But it's not significant statistics. 6. Male group had better rate of improvement than female in both gender, affected its left lesion. But it's not significant statistics.

• Clinical and Experimental Pediatrics
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• v.61 no.10
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• pp.332-337
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• 2018

Purpose: Bell's palsy is characterized by sudden onset of unilateral facial weakness. The use of corticosteroids for childhood Bell's palsy is controversial. This study aimed to identify clinical characteristics, etiology, and laboratory findings in childhood Bell's palsy, and to evaluate the efficacy of corticosteroid treatment. Methods: We conducted a retrospective analysis of children under 19 years of age treated for Bell's palsy between January 2009 and June 2017, and followed up for over 1 month. Clinical characteristics, neuroimaging data, laboratory findings, treatments, and outcomes were reviewed. Patients with Bell's palsy were divided into groups with (group 1) and without (group 2) corticosteroid treatment. Differences in onset age, sex, laterality, infection and vaccination history, degree of facial nerve palsy, and prognosis after treatment between the groups were analyzed. Results: One hundred patients were included. Mean age at presentation was $7.4{\pm}5.62years$. A total of 73 patients (73%) received corticosteroids with or without intravenous antiviral agents, and 27 (27%) received only supportive treatment. There was no significant difference in the severity, laboratory findings, or neuroimaging findings between the groups. Significant improvement was observed in 68 (93.2%) and 26 patients (96.3%) in groups 1 and 2, respectively; this rate was not significantly different between the groups (P=0.48). Conclusion: Childhood Bell's palsy showed good prognosis with or without corticosteroid treatment; there was no difference in prognosis between treated and untreated groups. Steroid therapy in childhood Bell's palsy may not significantly improve outcomes.

• Journal of Acupuncture Research
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• v.19 no.5
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• pp.112-123
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• 2002

Background and Objective : The evaluation of facial nerve function is a complex procedure. The House-Brackmann facial nerve grading system(H-B grade)and the Yanagihara grading system(Y-system) have been recommended as universal standards for assessing the degree of facial nerve palsy. The purpose of this study is to compare the effectiveness of Y-system and H-B system and to know the advantages of each system for each stage of incomplete recovery or sequelae of facial paralysis. Materials and Methods : A comparison between H-B grade and Y-system was studied with 137 evaluations of 61 cases of incomplete recovery or sequelae of peripheral facial paralysis. Each case was graded by using H-B system as a gross system and Y-system as a regional system before treatment, after 12 weeks and 6 months Results and Conclusions : The range of score in the Y-system 0-6, 8-16, 14-22, 24-34, 32-38, 38-40 were matched with grade VI, V, IV, III, II and I in the H-B system. The percentage of H-B grade III was the greatest among 137 evaluations and y-system showed the greatest score range. H-B system is easy to use but Y-system is more objective, quantitative and convenient to use in the incomplete recovery or sequelae state.

• Journal of Acupuncture Research
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• v.30 no.5
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• pp.155-167
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• 2013

Objectives : This research was conducted to investigate the factors that affect the level of facial nerve damage. Methods : From October 2009 to September 2013, the total number of 581 patients of Bell's palsy and Ramsay-Hunt syndrome visited Facial Palsy Center in Kyung Hee University Hospital at Gangdong for Traditional Korean and Western combined medical treatment. Of these, 453 patients of peripheral facial nerve palsy were selected for the research. After reviewing the medical records that have details of age, gender, diagnosis(Bell's palsy and Ramsay-Hunt syndrome), onset, underlying diseases(DM, HTN), and HbAlc value, the analysis on the influence factors on the level of facial nerve damage was drew out. Results : The axonal loss rate of oris branch and nasal branch were significantly higher than the axonal loss rate of frontal branch and oculi branch. In addition, the frequency of becoming a major damaged branch was also high in the oris branch nasal branch. The factors by month, weather, smoking, and alcohol did not influence EMG axonal loss rate. Male rather than female and patient with Rasmay-Hut syndrome rather than Bell's palsy had a higher axonal loss rate in all branches. Of those, front of branch of male was remarkably higher than female. Patient with DM as P/H had high axonal loss rate in all branches. Patient with HTN as P/H had high axonal loss rate in all branches except for oris branches. Patients with DM and HTN group had significantly higher value from the average of axonal loss rate than patients who are only with HTN and without DM/HTN. DM alone group had significantly higher value than patients who are without DM/HTN. However, HTN alone was not significantly high. By analysing HbAlc of the patients who were hospitalised regardless DM, axonal loss rate was high in the order of DM group, preDM group, normal group. Nevertheless, only DM group showed higher axonal rate statistically than normal group. Considering DM and HbA1c value, the patients can be divided into 4 different groups of hkDM, lkDM, hfDM and nDM. By analysing those groups, the average damaged value of the groups with diagnosis followed by treatment(lkDM, hkDM) were higher than the average rate of hfDM and statistically higher than the rate of the nDM. Conclusions : The influential factors of increasing the level of EMG damage are male(only for the frontal branch), age above sixties, HTN, DM, and HbAlc value above 6.5. Besides, the negligible factors are month, season, diagnosis, alcohol, and smoking. Further research including clinical prognosis should be conducted.

• The Korean Journal of Pain
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• v.5 no.2
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• pp.263-268
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• 1992

Involvement of the facial nerve(herpes zoster oticus, Ramsay Hunt Syndrome) is a rather common clinical syndrome. It begins with unilateral ear pain, followed shortly by a peripheral facial palsy. Paresis or paralysis may affect the muscles of facial expression, which also close the eyelids. The levator palpebrae which is innervated by the 5th cranial nerve is spared, so the eye may remain open. The rash is usually confined to the tympanic membrane and the external auditory canal. It may spread to involve the outer surface of the lobe of the ear, anterior pillar or the fauces and mastoid. There also may be a loss of taste in the anterior two thirds of tongue. At time, the auditory nerve involvement produces tinnitus, deafness and vertigo. The 5th, 8th and 10th nerves and even the upper cervical spinal nerve can be involved presumedly on the base of spread of the infective process along anastomotic connections between the facial nerve. The facial paralysis is identical to that of Bells palsy. Frequently the recovery of facial nerve function is incomplete, leaving the patient with some residual facial weak ness. We experienced 2 cases of Ramsay Hunt Syndrome. The first patients, 55 year old male, visited our pain clinic on the day when his left facial nerve start to paralyze. We injected 6 ml of 0.25% bupivacaine into his left stellate ganglion 15 times. TENS was also applicated simultaneously. His facial paralysis was recovered completely 3 weeks after treatment without any complications. Another one, 53 year old male, visited us 7 weeks after onset of facial paralysis. He has been treated conventional oriental method(acupuncture, massage, warm application, etc). But the degree of his left facial paralysis didn't improve at all He has been treating with SGB 50 times and TENS for 2 months. Temporal and zygomatic branch of his left facial nerve recovered nearly completely but buccal and mandibular branch did not recover completely. We are willing to insist on the early treatment is the best choice in managing of Ramsay Hunt Syndrome.

• Journal of Korean Medicine Rehabilitation
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• v.30 no.4
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• pp.233-241
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• 2020

This study was performed to evaluate the effect of high frequency therapy applied to the region branching to the external carotid artery for peripheral facial paralysis sequelae. A patient suffering with facial edema due to facial paralysis sequelae had been treated with acupuncture, high frequency therapy on the branch area to the external carotid artery for 7 weeks. The evaluation of clinical outcome was done by degree of swelling by measuring the distance of the face and skin temperature of face through digital infrared thermographic imaging. After treatment, the patient's degree of swelling and the temperature difference between the affected side and normal side was decreased. In addition, the temperature was changed in the entire facial area as well as the treatment point of high frequency therapy. This result shows that acupuncture combined with high frequency therapy at the region branching to the external carotid artery could be an effective way to improve facial blood flow, although further clinical studies will be needed.