• Archives of Craniofacial Surgery
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• v.22 no.6
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• pp.303-309
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• 2021

Background: Transferring the hypoglossal nerve to the facial nerve using an end-to-end method is very effective for improving facial motor function. However, this technique may result in hemitongue atrophy. The ansa cervicalis, which arises from the cervical plexus, is also used for facial reanimation. We retrospectively reviewed cases where facial reanimation was performed using the ansa cervicalis to overcome the shortcomings of existing techniques of hypoglossal nerve transfer. Methods: The records of 15 patients who underwent hypoglossal nerve transfer were retrospectively reviewed. Three methods were used: facial reanimation with hypoglossal nerve transfer (group 1), facial nerve reanimation using the ansa cervicalis (group 2), and sural nerve interposition grafting between the hypoglossal nerve and facial nerve (group 3). In group 1, the ansa cervicalis was coapted to neurotize the distal stump of the hypoglossal nerve in a subset of patients. Clinical outcomes were evaluated using the House-Brackmann (H-B) grading system and Emotrics software. Results: All patients in group 1 (n= 4) achieved H-B grade IV facial function and showed improvements in the oral commissure angle at rest (preoperative vs. postoperative difference, 6.48° ± 0.77°) and while smiling (13.88° ± 2.00°). In groups 2 and 3, the oral commissure angle slightly improved at rest (group 2: 0.95° ± 0.53°, group 3: 1.35° ± 1.02°) and while smiling (group 2: 2.06° ± 0.67°, group 3: 1.23° ± 0.56°). In group 1, reduced tongue morbidity was found in patients who underwent ansa cervicalis transfer. Conclusion: Facial reanimation with hypoglossal nerve transfer, in combination with hypoglossal nerve neurotization using the ansa cervicalis for complete facial palsy patients, might enable favorable facial reanimation outcomes and reduce tongue morbidity. Facial reanimation using the ansa cervicalis or sural nerve for incomplete facial palsy patients did not lead to remarkable improvements, but it warrants further investigation.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.32 no.3
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• pp.254-261
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• 2019

Objective : Miller-Fisher syndrome(MFS) is a type of acute inflammatory polyneuropathy, a disease characterized by abnormal muscle coordination, absence of tendon reflexes, and paralysis of the eye muscle. This study is to report a case of delayed facial palsy and dizziness in Miller-Fisher syndrome, treated with traditional Korean medicine. Methods : A 57-year-old male was diagnosed with Miller-Fisher syndrome accompanied by neurological symptoms such as right facial palsy and dizziness. He received traditional Korean medicine treatment such as acupuncture(including pharmacopuncture, needle embedding therapy, electroacupuncture) and herbal medicine for 17 days. Results : Each neurological symptoms were improved after traditional Korean medicine. In case of facial palsy, House Brackmann Grading System was reduced form grade 3 to grade 2, and Sunnybrook Scale was improved from 39 to 55. Also, other symptoms such as dizziness and headache was also improved. Conclusions : This case report suggests that traditional Korean medicine may have a role in treating neurological symptoms such as facial palsy and dizziness in patient diagnosed with Miller-Fisher syndrome.

• The Journal of Pediatrics of Korean Medicine
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• v.37 no.1
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• pp.58-72
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• 2023

Objectives The purpose of this study is to analyze the latest clinical trends in peripheral facial nerve palsy pediatric and adolescent patients who treated in Korean medicine hospital. Methods The study was conducted based on 185 cases of pediatric and adolescent patients with peripheral facial nerve paralysis who visited Korean medicine hospital from January 2017 to June 2022. Results The mean age of onset of facial nerve paralysis in children and adolescents was 11.7 years, and the incidence rate was higher in boys than in girls. The seasonal distribution was the most common in autumn, and 91.4% were diagnosed with Bell's palsy. The recurrence rate was 7.6%. The severity was evaluated on the House-Brackmann Grading System (HBGS) scale, and the most common was Grade III. It took an average of 6.5 days from the date of onset to visit the hospital, and 75.7% visited the hospital within a week from the date of onset. Hospitalized treatment was 69.2%. The higher the HBGS grade, the more hospitalized treatment was, and the total number of treatments and the duration of treatment tended to increase. The average treatment period from the first visit date was 119.6 days. 17.8% received only Korean medicine treatment, and 69.2% took Western medicine with herbal medicine. Conclusions In this study, there was a difference in the average treatment period from previous studies according to the study period setting. Long-term studies on the recovery rate and prognosis of pediatric facial paralysis are needed.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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• pp.785-796
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• 2019

Objective: Facial nerve palsy causes both facial muscle malfunction and mental illness. Because a facial nerve palsy lesion shows on the face, it can have serious effects on social relationships and mental health. Many facial nerve palsy patients undergo anxiety, depression, and social phobia. In this study, a facial nerve palsy patient with sleep disorder was admitted to the Korean medicine hospital for treatment. Methods: The patient with facial nerve palsy and sleep disorder was treated with herbal medicines, acupuncture, herbal acupuncture therapy, and physical therapy. We used the House Brackmann grading system and Yanagihara's Unweighted Grading System to assess changes in facial nerve palsy symptoms and the Korean Modified Leeds Sleep Evaluation Questionnaire to assess the sleep disorder. Results: The patient was hospitalized for 18 days and showed a recovery from both facial nerve palsy and sleep disorder symptoms without any adverse events. We conclude that patients with facial nerve palsy should be treated from both the physical and mental health perspectives.

• 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.

• Korean Journal of Acupuncture
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• v.33 no.4
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• pp.183-193
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• 2016

Objectives : The purpose of this study is to find out the effect of Postural Yinyang Correction of TMJ(Functional Cerebrospinal Therapy; FCST) on Bell's palsy. Methods : We reviewed the medical records of 41 patients who were treated for Bell's palsy at the Dept. of Acupuncture and Moxibustion, Dong-Eui University from January $1^{st}$, 2016 to August $31^{st}$, 2016. The patients were divided into 2 groups: Group A(n=21), and Group B(n=20). Patients in Group A were treated by Korean Medical Treatments with FCST using ABA(Accurate Balancing Appliance), a standard intra-oral appliance. Patients in Group B were treated by Korean Medical Treatments without FCST. To estimate the efficacy in recovering palsy, we analyzed the House-Brackmann Grading Scale and Yanagihara's Unweighted Grading System. Results : In both groups, H-B grades were improved significantly during each period except the period from the first visit to one week later(P01). The improvement of H-B grade during each period in Group A is higher than Group B except the period from one week later to two weeks later, but statistically insignificant. In Group A, Y-score was significantly improved during each period except during P01. In group B, Y-score was significantly improved during each period except during P01 and the period from the first visit to two weeks later. The improvement of Y-score during each period in Group A is higher than Group B, but statistically insignificant. Conclusions : FCST using Standard Intraoral Appliance may be helpful in treating Bell's Palsy, but the further researches are needed.

• Journal of Acupuncture Research
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• v.25 no.3
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• pp.163-177
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• 2008

Objectives : This study was designed to evaluate clinical prognosis factors of Bell's palsy patients. Methods : The 100 subjects were chosen from 262 patients over 20years old who was diagnosised Bell's palsy through Acupuncture & Moxibustion and ENT medical specialist after visiting the hospital within 8days of onset of peripheral facial palsy and after Oriental-Western Medicine Treatment, recovered completely or had over three months cares because of incomplete recovery Oriental-Western Medicine Treatment included Acupuncture Treatment, Herb med treatment, medicines treatment, Physical therapy and Electrodiagnostic Test was operated after 7 to 10days after outbreaks of the disease. Clinical prognosis factors were analyzed using House-Brackmann grading system(HBGS) as a measurement of the degree of Facial Palsy. Collected data were analyzed as Chi-Square test, ANOVA test, Independent-Samples t-test regression analysis using SPSS 12.0 WIN Program. Results : 1. There was a significant difference in the results of treatment according to site of palsy, degree of initial palsy, time of initial recovery and existence of recovery after 3weeks from onset as clinical prognosis factors of Bell's Palsy, However, a statistically significant difference was not shown in the results of treatment according to gender, age, existence of Post Auricular Pain, Hypertension, Diabetes and existence of relapse. 2. As a result of overall treatment, 85% of patients were recovered almost entirely and 15% were not recovered completely. 3. There was a significant difference in the onset of Post Auricular Pain and duration of Post Auricular Pain according to the degree of Post Auricular Pain. 4. There was a significant difference in the degree of initial palsy and degree of palsy after 3weeks from onset according to the existence of Post Auricular Pain. However, a statistically significant difference was not shown in the period of time until initial treatment, The time of initial recovery, (H-B), The period from onset to recovey, ENoG value. Conclusions : Based on the above results, prognosis of Bell's palsy was affected by degree of initial palsy, time of initial recovery and existence of recovery after 3weeks from onset.

• Journal of Acupuncture Research
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• v.25 no.3
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• pp.19-28
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• 2008

Objectives : The purpose of this study is to investigate the therapeutic effects of oriental medical treatment and oriental-western medical treatment on Bell's palsy. Methods : From 1st June, 2006 to 31th August, 2007, 30 Bell's palsy patients who visited the Facial palsy center at East-West Neo Medical Center within 7days of onset and treated for more than 4weeks were randomly divided into two groups. Group A was treated with oriental medical therapy(Acupuncture, Herb, Physical therapy) and Group B with both oriental and western medical therapy(Acupuncture, Herb, Physical therapy, Administration of prednisone). We evaluated the treatment effect of each group with the House-Brackmann Gross Grading System before treatment, after 1week, 2weeks, 3weeks and 4weeks of treatment. Results : After 1week of treatment, Group A showed better performance compared with Group B. After 3weeks and 4 weeks of treatment, Group B showed better performance than Group A. Conclusions : These results proved that combination treatment of oriental and western medicine was more effective than just oriental medical treatment in long term treatment of Bell's palsy. But we discovered that there were no significant differences between the two groups.

• Journal of Acupuncture Research
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• v.23 no.6
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• pp.229-238
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• 2006

Background and Objetive : The aim of this study is to report 3 cases of facial palsy following microvascular decompression in hemifacial spasm patients. It is a rare disease, with few research on the effect of acupuncture therapy on it. Material and Method : We selected 3 cases of facial palsy following microvascular decompression in hemifacial spasm patients, among patients who visited the Facial palsy Clinic of Kyunghee Oriental Medical Center. We treated them with acupuncture therapy(ST6, ST4, BL2, TE17, GV24, GV14, and Ex-HN4 of the healthy side, and LI4 and ST36 of both sides) and aroma therapy. After treatment we observed and checked any changes within clinical symptoms using the House-Brackmann Grade and the Yanagihara's Unweighted Grading System. Result and Conclusion : 1. All three cases were of hemifacial spasm patients who had facial palsy following microvascular decompression. The patients visited 27 months(Case1), 2 months(Case2) and 7 months(Case 3) after the surgery respectively. 2. Period of time till complete recovery is 23 months(Case1), 8 months(Case2) and 3 month (Case3) respectively. 3. All three cases had symptoms of sequelae: retraction of mouth toward the healthy side and involuntary spasm of lips. The later the initiation of treatment after the sugery, the more severe symptoms of sequelae.