• Journal of Acupuncture Research
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• 제29권4호
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• pp.35-42
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• 2012

Objectives : This study was to observe clinical application of auto-microneedle therapy system (AMTS) in patients with peripheral facial paralysis. Methods : 27 peripheral facial paralysis patients were observed after taking AMTS at Facial Palsy Center, Kyung Hee University Oriental Medicine Hospital from March 1, 2011 to January 9, 2012. We assessed the symptoms of facial paralysis with Yanagihara unweighted grading system, Sunnybrook facial grading system(SBGS) and facial disability index(FDI), and observed adverse events and total safety of the treatment. Results : The scores of facial palsy scales increased after AMTS in Yanagihara grading system and Sunnybrook facial grading system. AMTS-related adverse events were mild pain(5.9%) and fatigue(3.5%), which needed no extra treatment. The total safety evaluation was between 'safe' and 'nearly safe' level. There were no other serious adverse events. In addition, patients were satisfied with subjective improvement including facial tingling and numbness. Conclusions : AMTS can be applied as an adjunctive treatment for patients with peripheral facial paralysis due to its safety and clinical usefulness. It is easier to stimulate wide skin area in a short time. Further clinical research is required to investigate the effectiveness of ATMS in a more rigorous RCTs.

• Journal of Acupuncture Research
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• 제28권1호
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• pp.117-124
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• 2011

Objectives : Bell's palsy is the most common acute facial paralysis but its causes still unclear. At present, one of the most widely accepted cause is viral infections, and generally socioeconomic factors influence the viral infections. The purpose of this study is to investigate the relationship of incidence of facial palsy with socioeconomic factors. Methods : Seventeen patients with a acute facial palsy, who volunteered and completed all of the assessment measures participated. Using data on 17 participants, we examined the independent contribution of education, income, and occupation to a risk factor of severe facial palsy. Severity of global facial impairment was assessed by the facial disability index (FDI), the house-brackmann facial nerve grading system, WHO quality of life - bref (WHOQOL-BREF) and visual analogue scale (VAS) about discomfort of life. Results : There was no correlation between severity of facial palsy and gender, marriage, education, or occupation. Age greater than 60 years (p<0.05), and low monthly income(p<0.05), poor self-rated health was associated with greater severity of idiopathic facial paralysis. Conclusions : The number of subjects with facial palsy in our study (n-17) was small, and therefore generalization to larger patient populations might be unwarranted. But according to the outcome, we suggest that socioeconomic factors, especially low monthly income influence severity of bell's palsy.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.2.1-2.6
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• 2020

Background: Facial palsy treatment comprises static and dynamic techniques. Among dynamic techniques, local temporalis transposition represents a reliable solution to achieve facial reanimation. The present study describes a modification of the temporalis tendon transfer using a cryopreserved fascia allograft. Case presentation: Between March 2015 and September 2018, seven patients with facial palsy underwent facial reanimation with temporalis tendon transfer and fascia lata allograft. Patients with long-term palsy were considered, and both physical and social functions were evaluated. The mean follow-up time was 21.5 months. No immediate complications were observed. Patients reported improvement in facial symmetry both in static and dynamic. Improvement was noticed also in articulation, eating, drinking, and saliva control. The Facial Disability Index revealed an improvement both in physical function subscale and in the social/well-being function subscale. Conclusions: This modified orthodromic technique allows to reduce the operative time and the risk of complications connected to the use of autologous tissues. The use of the cryopreserved fascia allografts from cadaveric donors seems to provide promising and long-standing results in the treatment of facial palsy.

• 한방재활의학과학회지
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• 제33권2호
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• pp.87-94
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• 2023

This study aims to demonstrate the effectiveness of facial chuna manual therapy in treating the sequelae of Bell's palsy. Four patients were treated with facial chuna manual therapy once a week for 4 weeks, consisting of facial muscle massage, acupoint pressure, contracture chuna, and synkinesis chuna. The changes in symptoms (contracture and sysnkinesis) were measured using the Sunnybrook Facial Grading Scale (SFGS), Synkinesis Assessment Questionnaire (SAQ), Facial Disability Index (FDI), Contracture/Synkinesis scale using a facial scanning system, Numeric Rating scale (NRS) for synkinesis or contracture, and Was It Worth It questionnaire. After treatments, SFGS, Contracture/Synkinesis scale, and NRS for synkinesis or contracture showed significant improvements. SFGS increased in three cases from 39~76 to 52~85 score. SAQ decreased in two cases from 53.33~57.78 to 40.00~55.56. FDI increased in three cases from 120~128 to 138~145. These results suggest that Korean medicine treatment, including facial chuna manual therapy can be effective in improving the sequelae of Bell's palsy.

• Archives of Plastic Surgery
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• 제49권5호
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• pp.633-641
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• 2022

Introduction In chronic facial palsy, synkinetic muscle overactivity and shortening causes muscle stiffness resulting in reduced movement and functional activity. This article studies the role of multimodal therapy in improving outcomes. Methods Seventy-five facial palsy patients completed facial rehabilitation before being successfully discharged by the facial therapy team. The cohort was divided into four subgroups depending on the time of initial attendance post-onset. The requirement for facial therapy, chemodenervation, or surgery was assessed with East Grinstead Grade of Stiffness (EGGS). Outcomes were measured using the Facial Grading Scale (FGS), Facial Disability Index, House-Brackmann scores, and the Facial Clinimetric Evaluation scale. Results FGS composite scores significantly improved posttherapy (mean-standard deviation, 60.13 ± 23.24 vs. 79.9 ± 13.01; confidence interval, -24.51 to -14.66, p < 0.0001). Analysis of FGS subsets showed that synkinesis also reduced significantly (p < 0.0001). Increasingly, late clinical presentations were associated with patients requiring longer durations of chemodenervation treatment (p < 0.01), more chemodenervation episodes (p < 0.01), increased doses of botulinum toxin (p < 0.001), and having higher EGGS score (p < 0.001). Conclusions This study shows that multimodal facial rehabilitation in the management of facial palsy is effective, even in patients with chronically neglected synkinesis. In terms of the latency periods between facial palsy onset and treatment initiation, patients presenting later than 2 years were still responsive to multimodal treatment albeit to a lesser extent, which we postulate is due to increasing muscle contracture within their facial muscles.

• The Journal of Korean Physical Therapy
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• 제26권4호
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• pp.240-248
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• 2014

Purpose: The purpose of study was to determine the effects of muscle reeducation training in patients with acute facial nerve paralysis. Methods: Thirty patients were randomly assigned to either the experimental group (n=15) or the control group (n=15). The experimental group received muscle reeducation training for 20 minutes after electrotherapy and the control group received conventional electrotherapy for only 40 minutes. Therapeutic intervention for each group was performed four times per week for four weeks. The patients were measured for recovery of paralysis using the House-Brackmann Grading System (H-B grade), the Movement Distance of Mouth, Nasolabial Angle (NA), and Facial Disability Index (FDI). Results: In within group comparison, the experimental group showed significant improvements for all variables (p<0.01). In comparison between two groups, the experimental group showed relatively greater significant improvements for all variables (p<0.01). Conclusion: These findings suggest that muscle reeducation training is more effective than conventional therapy in improving the condition of patients with facial nerve paralysis. In particular, the results of this study indicate that muscle reeducation training can be recommended by clinicians since it provides more benefits.

• 한방안이비인후피부과학회지
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• 제22권1호
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• pp.157-171
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• 2009

Objective : The face is very important for human communication. So facial palsy patients experience not only physical disturbances but also serious emotional stress. Therefore the focus of treatment must be to not only aid the recovery of objective symptoms but also the improvement of subjective quality of life. However there has not been enough Oriental Medical study in this field until now. Thus this study was begun to suggest a useful index for the treatment of facial palsy. Methods : Grade of paralysis, sequelas, and quality of life were used for evaluation. To evaluate Grade of paralysis, House-Brackman Grade was used as the Gross scale and Kim's Grade was used as the Regional scale. Sequelas were evaluated by muscle contraction, synkinesis, NA, and grade of philtrum tilt. Quality of life was evaluated by SF-36v2, Facial Disability Index, and Vas. Results & Conclusion : 1. The change of grade of paralysis between the early and the present time reveals remarkable improvement statistically. 2. There was a remarkable improvement in all parts of quality of life except several areas of SF-36(RP, RE, MH, VT) 3. In only PF(Physical Function) of FDI, quality of life increased remarkably according to the improvement of grade of paralysis. 4. There is the positive relationship among Kim's grade, HB grade and Synkinesis 2. 5. Synkinesis among sequelas has the greatest effect on quality of life. And muscle contraction, change of NA, and grade of philtrum tilt also affect quality to some extent. 6. There was no remarkable relationship between the period of illness and change of quality of life. 7. Change of NA is shown after 3 months of illness and synkinesis becomes worse after 6 months of illness.

• Journal of Acupuncture Research
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• 제33권3호
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• pp.89-99
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• 2016

Objectives : This study was performed to develop objective methods for evaluating facial palsy sequelae using a 3D Facial Scanning System. Methods : Fifty-eight patients with facial palsy sequelae were selected. Their medical records were reviewed to collect demographic data, facial palsy sequelae evaluation, Facial Disability Index questionnaire, and test results (3D Facial Scanning System). Five different facial expressions (at rest, eye closure, eyebrow elevation, smiling, and whistling) were photographed. Sunnybrook Scale was associated with distances between predetermined facial points. Results : The average Sunnybrook composite score was $58.88{\pm}17.31$. Secondary movements (mouth to eye synkinesis, contracture of eye, and contracture of mouth) showed significant difference according to the Sunnybrook Scale. In voluntary movements, eyebrow height at eyebrow elevation, length between mouth angle and central line while whistling, and eyelid width at maximum eye opening showed significant difference. Facial palsy Sequelae Index (FSI) was correlated with Sunnybrook sub-scales (resting symmetry, voluntary movement, and synkinesis). Conclusion : These results demonstrate that a 3D Facial Scanning System is useful for evaluating facial palsy sequelae. This method may facilitate objective evaluation for facial palsy sequelae and it could be applied in clinical trials.

• 한방안이비인후피부과학회지
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• 제23권2호
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• pp.174-185
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• 2010

Objective : In period of convalescence and aftereffect, facial palsy patients suffer from social and psychological problems, besides experiencing physical inconvenience. So Quality of life is important Evaluation in treatment or facial palsy. Nevertheless the aims of recent study were only trying to explain about objective symptoms. Therefore, Oriental-Western Medicine was performed, effectiveness of treatment were measured in Quality of life. Methods : Acute facial palsy patients who visiting whin 5days completed questionnaire about Quality of life, if he(or she) participated voluntarily. Questionnaire are comprised of general characteristics, Facial Disability Index(FDI), WHOQOL-BREF, VAS and House-Brackmann grade. Questionnaire used two times, the first medical examination and 4weeks later after starting Oriental-Western Medicine. The statistical analysis was performed by GraphPad Prism 4.0. T-test was used to verify effectiveness between the two groups. Results : 1. When we compared the first medical examination with 4weeks later, score of FDI-Physical function and FDI-Social/Well-bieng function increased but they were not valid statistically. 2. When we compared the first medical examination with 4weeks later, in WHOQOL-Brefoverall domain and physical domain, score increased. In WHOQOL-Bref-psychological, Social, Environment domain, score decreased. but, they were not valid statistically. 3. VAS, House-Brackmann grade decreased, but, they were not valid statistically. Conclusion : The number of subjects with facial palsy in our study(N=5) was too small, and the period of study(4 weeks) was short, too. For this reason, our data were not valid statistically. But Facial palsy Patient's Quality of life has risen.

• Journal of Acupuncture Research
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• 제41권1호
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• pp.53-62
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• 2024

Background: The aim of this study is to determine the correlation between clinical assessment scales, self-assessment scales, and surface electromyography (SEMG) for facial nerve palsy. Methods: This study assessed 32 cases of facial nerve palsy on the first visit, 11 cases on the second visit, and 9 cases on the third visit to the Korean medicine hospital, university. This study was conducted from October 22, 2022, to December 22, 2022. The patients were evaluated using SEMG, clinical assessment scales, and self-assessment scales 3 times. The House-Brackmann grading systems (HBGS), Yanagihara unweighted grading system (Y-score), facial disability index, numerous rating scale, and accompanying symptoms of facial nerve palsy were used for assessment. Moreover, statistical correlation was analyzed using Pearson correlation. Results: On Visit 1, Significant correlations were observed between the results of SEMG and other clinical assessment scales as well as between SEMG-F (frontalis) and different parts of the Y-score. On Visit 2, significant correlations were observed between the results of SEMG and HBGS as well as between SEMG-F and the detailed parts of the Y-score. On Visit 3, significant correlations were observed only between SEMG-F and the detailed parts of the Y-score. A significant correlation was also observed between the changes in the clinical assessment scales on Visits 1 and 3 and between the changes in SEMG-F and those in the patient self-assessment scales. Conclusion: These findings suggest that SEMG can be used to evaluate facial nerve palsy in conjunction with the use of other clinical assessment scales.