COMPARATIVE STUDY ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE AND WESTERN MEDICINES FOR TREATMENT OF PERIPHERAL FACIAL PALSY

Subjective: To observe the therapeutic effect of acupuncture in treatment of acute peripheral facial paralysis. Methods: A total of 80 cases of facial palsy were randomly divided into acupuncture group (n=50) and Western medicine (control) group (n=30). In acupuncture group, Cuanzhu (BL 2), Sibai (ST 2), Yangbai (GB 14), etc. were punctured, combined with TDP radiation, cupping or administration of Chinese medicinal herbs according to the concrete situations. Acupuncture treatment was given once daily, with 6 days being a therapeutic course, continuously for 4 courses. In control group, patients were treated with intravenous injection of “energy mixture”, dexamethasone, compound Danshen injectio, etc.. Results: After treatment, in acupuncture group, of the 50 cases, 48 were cured and 2 had improvement, with the effective rate being 100%; among them, 12 cases were cured in 7 days, 23 cured in 8～14 days, 10 cured in 15～21 days and 3 cured in 22～28 days. In control group, of the 30 cases, 19 were cured, 8 had improvement and 3 had no apparent changes, with the effective rate being 90%. Of the 19 cured cases, 5 were cured within 8～14 days, 10 cured in 15～21 days and 4 cured in 22～28 days. Conclusion: In treatment of acute periphery facial palsy, acupuncture is obviously superior to Western medicines in the therapeutic effect and cure duration.

A Rare Case of Facial Palsy Due to Mucormycosis

A very uncommon instance of facial nerve palsy involving isolated temporal bone with associated uncontrolled diabetes mellitus has been noticed. A 53-year-old diabetic male presented himself with facial asymmetry, ear pain, and discharge in the right ear of one-month duration. Clinical examination revealed grade IV [House-Brackmann] right sided facial palsy, and otoscopy of small central perforation. Clinically acute otitis media with facial palsy diagnosis was made. There was minimal response to medical treatment. As per CT scan and audiometry findings, patient was subjected for exploratory mastoidectomy showing pale granulation tissue involving geniculate ganglion of facial nerve. The histopathology was suggestive of mucormycosis, an unusual presentation in middle ear. The patient was treated with injectable Amphotericin B. This case highlights a rare cause of isolated facial palsy and physicians should be aware of such atypical clinical presentation.

TREATMENT OF 150 CASES OF FACIAL PALSY WITH ACUPUNCTURE PLUS TDP IRRIDIATION

In the present paper, the author summarizes the results of treatment of 150 cases of facial palsy with acupuncture plus TDP irradiation. Main acupoints used are Baihui (GV 20), Yintang (EX HN 3), Sibai (ST 2), Dicang (ST 4) and Hegu (LI 4). After insertion, the needles are retained but not manipulated, and the acupoints are irradiated with TDP for 20-60 min every time. The treatment is conducted once daily, with 10 sessions being a therapeutic course. Following 6-28 sessions of treatment, of the 150 cases, 145 are cured, 2 experience remarkable improvement and 3 have improvement, with the total effective rate being 100%. The fact indicates that acupuncture plus TDP irradiation is rather effective in the treatment of facial palsy.

EFFECT OF NEEDLING STIMULATION QUANTITY ON THE THERAPEUTIC EFFECT OF ACU-MOXIBUSTION IN THE TREATMENT OF PERIPHERAL FACIAL PALSY IN THE EARLY STAGE

Objective:To observe the correlation between needling stimulation quantity and the therapeutic effect of acupuncture in the treatment of early stage of peripheral facial palsy. Methods: Sixty three peripheral facial palsy patients were randomized into treatment group (n=33) and control group (n=30). In treatment group, Taiyang (EX HN 5), Jingming (BL 1) and Hegu (LI 4) were punctured with gauge 36 acupuncture needles and stimulated with light twirling reinforcing method (about 200 times/min), the acupuncture needles were retained for 20 min. In addition, moxibustion was also applied to Fengchi (GB 20) and Qianzheng (EX HN 17) following puncturing them with gauge 30 filiform needles. In control group, conventional twirling reducing method (about 60 times/min) was applied to Yangbai (GB 14), Cuanzhu (BL 2), Sizhukong (TE 23), etc., following puncturing them with gauge 28 filiform needles. Additionally, thermal needle was applied to Fengchi (GB 20), Yifeng (TE 17) and Jiache (ST 6), with the needles retained for 40 min. Results: Following 10 days’ treatment, of the 33 and 30 cases in treatment and control groups, 21 (63.0%) and 12 (40.0%) were cured, 7(21.1%) and 5 (16.7%) had remarkable improvement, 4 (12.1%) and 9 (30.0%) were effective, and 1 (3.0%) and 4 (13.3%) failed in the treatment, with the cure plus markedly effective rates being 84.8% and 56.7% respectively. Statistical analysis shows that in acupuncture treatment of early stage of facial palsy, light stimulation is superior to that of heavy stimulation in the therapeutic effect.

Therapeutic Efficacy Observation on Mild Lifting and Superficial Pulling Point-towards-point Needling for Intractable Facial Palsy

Objective: To observe and compare the clinical effects of combining mild lifting and superficial pulling point-towards-point needling and point injection and integrated standard electroacupuncture(EA) with intramuscular injection of Mecobalamin for intractable facial palsy. Methods: Eighty cases with intractable facial palsy were randomized into a treatment group and a control group, 40 in each group. Cases in the treatment group were treated with mild lifting and superficial pulling point-towards-point needling Xiaguan(ST 7) coupled with point injection of Mecobalamin. Cases in the control group were treated with standard EA coupled with intramuscular injection of Mecobalamin. After three courses of treatment, the between-group comparisons of Portmann scores and clinical effects were conducted. Results: After three courses of treatment, the Portmann scores in both groups were higher than the scores before treatment(P<0.01); the Portmann score in the treatment group was higher than that in the control group(P<0.05) and the total effective rate in the treatment group was higher than that in the control group(P<0.05). Conclusion: Combining mild lifting and superficial pulling point-towardspoint needling and point injection of Mecobalamin could obtain better effect for intractable facial palsy than standard EA coupled with intramuscular injection of Mecobalamin.

Misdiagnosis of Facial Nerve Palsy: A Case Report of Sporadic Vestibular Schwannomas (Non-NFM2) Causing Facial Nerve Palsy Be Misled by Bell’s Palsy in a Child

We report a case of a rare sporadic Vestibular Schwannoma of a 9-month-old girl who had a right-sided lower motor type facial nerve palsy. The patient was initially diagnosed with Bell’s palsy and received steroid treatment accordingly, two months later the patient’s condition deteriorated, and further evaluation of CT and MRI brain was conducted that showed a mass lesion in the posterior fossa causing compression on the facial nerve. Misdiagnosis of facial nerve paralysis is common among children due to multiple related etiologies and varying rates of incidence in comparison to adults. The authors hope to address this issue in this report. Background: Facial nerve paralysis has been a matter of concern for many researchers to understand its nature, causes and presentation according to different age groups. In adults, Bell’s palsy (BP), the idiopathic form of facial nerve paralysis, is more common compared to children where most cases are due to secondary etiologies. Therefore, pediatricians are in an important position to identify these patients early in order to launch the most effective diagnostic and treatment approaches.

The Anti-Inflammatory Effects of NaCl with KCl as a Potent Graphene Exfoliator in a Patient with Guillaine-Barré Syndrome and Facial Nerve Palsy

Guillain-Barré syndrome is a rare but fatal autoimmune disease of unknown origin. Infectious disease is the most common etiology of Guillain-Barré syndrome. We had a 75-year-old female patient with Guillain-Barré syndrome and a 90-year-old male patient with facial nerve palsy admitted to our hospital. Both patients experienced recovery from early Guillain-Barré syndrome and peripheral facial nerve palsy after receiving intravenous infusion of NaCl with KCl solution and taking vitamin C.

Awareness of Hail Region Population about Facial Nerve Palsy (Seventh Cranial Nerve Palsy)

Background: Facial nerve palsy (seventh cranial nerve palsy) is a common neurological problem. The etiology is not fully understood but it is thought to be due to injury or compression throughout the seventh cranial nerve course. The study aimed to evaluate the awareness of the Hail region population about facial nerve palsy, its risk factors, methods of treatment, and prognosis. Methodology: This cross-sectional descriptive study was conducted in the Hail region from March to June 2022. The study involved 224 participants in the age group 18 - 65 years and data was collected through Google self-administered questionnaire. Results: 65.2% of the participants were 18 - 25 years, 20.1% were 26 - 35 years and 14.7 were above 35 years. 91.9% think that exposure to cold air is the leading cause followed by viral infections (30.4%), stroke (27.6%), and genetic factors (13.8%). diabetes (8.5%), evil eye (7.1%), magic (4%), pregnancy (0.4%) and vitamins deficiency (0.4%). 92% of participants think that facial nerve palsy is not contagious and 8% have no clear idea. 89.7% think that facial nerve palsy is curable, 83.9% think that physiotherapy is the treatment of choice, 94.6% agree that early medical assessment is essential for good outcomes and 92.9 believe that avoidance of cold air is the best method of prevention. Conclusion and Recommendations: The majority of participants show poor awareness regarding the etiology and the preferable treatment of facial nerve palsy. Public medical education and further wider studies are highly recommended.

Recovery from Bell’s palsy after treatment using uncultured umbilical cord-derived mesenchymal stem cells:A case report

BACKGROUND Bell’s palsy is an idiopathic facial palsy with an unknown cause,and 75%of patients heal spontaneously.However,the other 25%of patients continue experiencing mild or severe disabilities,resulting in a reduced quality of life.Currently,various treatment methods have been developed to treat this disease.However,there is controversy regarding their effectiveness,and new alternative treatments are needed.CASE SUMMARY The patient suffered from left-sided facial paralysis due to Bell’s palsy for 7 years.The patient received an uncultured umbilical cord-derived mesenchymal stem cell transplant eight times for treatment.After follow-up for 32 mo,the paralysis was cured,and there was no recurrence.CONCLUSION Uncultured umbilical cord-derived mesenchymal stem cell transplantation may be a potential treatment for patients with Bell’s palsy who do not spontaneously recover.

Analysis of post-traumatic growth status and its influencing factors in patients with facial palsy

Background:Facial nerve paralysis in patients occurs in varying degrees of self-image disorders,both physically and mentally,resulting in low self-esteem,anxiety,depression,and even suicide;however,there were few researches on psychological problems in facial palsy patients at home and abroad.This study's objective was to investigate post-traumatic growth(PTG)in facial nerve palsy patients and analyze its influencing factors.Methods:Using the convenience sampling method,a total of 47 patients with facial nerve paralysis were enrolled in the current study between June 1,2016,and May 31,2017.Post-traumatic growth rating scale was utilized to investigate the post-traumatic growth of these patients,and factors influencing patients'post-traumatic growth were analyzed through collecting the general sociological information,disease-related information,simple coping style questionnaire,and social support rating scale.Results:The total score of post-traumatic growth in patients with facial nerve paralysis was mean(M)=63.1,standard deviation(SD)=19.14.The ranking of five dimensional scores from high to low was as follows:new possibilities,personal strength enhancement,appreciation of life,mental changes,and improvement of relationships with others.Multiple linear regression analysis showed that six variables,namely,the personality type,duration with facial nerve paralysis,and four coping styles,consisting of three types of positive coping styles and one negative coping style,could explain 71.6%of the total post-traumatic growth score.Conclusions:Post-traumatic growth in facial nerve palsy patients is moderate.The personality type of patients,the disease duration,and the coping style are the primary influencing factors.Therefore,clinical staffs should perform personalized nursing protocol and psychological intervention for facial nerve palsy patients to reduce their negative mood,improve their compliance with treatment,and help them recover more rapidly.

Facial nerve palsy, headache, peripheral neuropathy and Kaposi's sarcoma in an elderly man

We present a case of an elderly man, who initially presented with right facial nerve palsy, ipsilateral headache, elevated erythrocyte sedimentation rate(ESR) and no fever. A presumptive diagnosis of giant cell arteritis was made and the patient was treated with highdose steroids. A temporal artery biopsy was negative. Several months later, while on 16 mg of methylprednisolone daily, he presented with severe sensorimotor peripheral symmetric neuropathy, muscle wasting and inability to walk, uncontrolled blood sugar and psychosis. A work-up for malignancy was initiated with the suspicion of a paraneoplastic process. At the same time a biopsy of the macular skin lesions that had appeared on the skin of the left elbow and right knee almost simultaneously was inconclusive, whereas a repeat biopsy from the same area of the lesions that had become nodular, a month later, was indicative of Kaposi'ssarcoma. Finally, a third biopsy of a similar lesion, after spreading of the skin process, confirmed the diagnosis of Kaposi's sarcoma. He was treated with interferon α and later was seen in very satisfactory condition, with no clinical evidence of neuropathy, normal muscle strength, no headache, normal electrophysiologic nerve studies, involution of Kaposi's lesions and a normal ESR.

A Rare Case of Suppurative Parotitis with Facial Nerve Palsy

Parotid mass causing facial nerve palsy is rare, and is associated with malignant tumours. Acute infection or abscess leading to facial nerve palsy is an extremely rare complication. A literature review revealed only 16 cases of facial nerve palsy associated with suppurative parotitis or parotid abscess. We present a case of deep parotid abscess which is complicated by facial nerve dysfunction.

Ophthalmic profile and systemic features of pediatric facial nerve palsy

Background: Facial nerve palsy(FNP) occurs less frequently in children as compared to adults but most cases are secondary to an identii able cause. These children may have a variety of ocular and systemic features associated with the palsy and need detailed ophthalmic and systemic evaluation.Methods: This was a retrospective chart review of all the cases of FNP below the age of 16 years, presenting to a tertiary ophthalmic hospital over the period of 9 years, from January 2000 to December 2008.Results: A total of 22 patients were included in the study. The average age at presentation was 6.08 years(range, 4 months to 16 years). Only one patient(4.54%) had bilateral FNP and 21 cases(95.45%) had unilateral FNP. Seventeen patients(77.27%) had congenital palsy and of these, five patients had a syndromic association, three had birth trauma and nine patients had idiopathic palsy. Five patients(22.72%) had an acquired palsy, of these, two had a traumatic cause and one patient each had neoplastic origin of the palsy, iatrogenic palsy after surgery for hemangioma and idiopathic palsy. Three patients had ipsilateral sixth nerve palsy, two children were diagnosed to have Moebius syndrome, one child had an ipsilateral Duane's syndrome with ipsilateral hearing loss. Corneal involvement was seen in eight patients(36.36%). Amblyopia was seen in ten patients(45.45%). Neuroimaging studies showed evidence of trauma, posterior fossa cysts, pontine gliosis and neoplasms such as a chloroma. Systemic associations included hemifacial macrosomia, oculovertebral malformations, Dandy Walker syndrome, Moebius syndrome and cerebral palsy.Conclusions: FNP in children can have a number of underlying causes, some of which may be life threatening. It can also result in serious ocular complications including corneal perforation and severe amblyopia. These children require a multifaceted approach to their care.

Clinical Observation of Combined Acupuncture and Medications in Treating 90 Cases of Facial Palsy

Peripheral facial palsy, namely Bell palsy, is one of the common diseases in the department of acupuncture. Facial palsy, popularly called wry mouthand

Children peripheral facial palsy treated with three therapies of strong stimulation: a randomized controlled trial

Objective To evaluate the clinical efficacy and safety of the three therapies of strong stimulation for children peripheral facial palsy so as to deal with the problem on the inactive acceptance of acupuncture in children.Methods Eighty cases of children peripheral facial palsy were randomized into a moxa stick group (group A) and a group with three therapies of strong stimulation (group B) .Baihui (GV 20) ,Sibai (ST 2) ,Dicang (ST 4) ,Jiache (ST 6) and the other acupoints were selected in the two groups and stimulated with half-needling technique.

针刺联合灵活调节治疗周围性面瘫临床观察

目的探究针刺联合灵活调节治疗周围性面瘫的临床效果。方法选择2021年1月—2022年12月符合入选标准的周围性面瘫患者64例,随机分为观察组和对照组,各32例。两组患者根据病情需要选用西药常规治疗,对照组在此基础上给予针刺治疗,观察组在此基础上给予针刺联合五位一体综合治疗。4个疗程后,观察两组患者治疗前后面神经功能分级情况及临床总有效率。结果观察组的临床总有效率为93.8%(30/32),高于对照组的78.1%(25/32)(P<0.05)。观察组H-B面神经功能分级优于对照组,差异有统计学意义(P<0.05)。结论针刺联合灵活调节治疗周围性面瘫,可有效改善面神经功能,提高临床效果。

多部位肌肉面神经电图检测对贝尔麻痹患儿面神经功能及预后的评估价值

目的探讨面神经电图(ENoG)检测多块面肌方法在贝尔麻痹(BP)患儿面神经功能评估及早期预测预后中的价值。方法选取2020年6月至2022年9月在昆明医科大学附属儿童医院诊治的90例BP患儿,首诊时应用ENoG检测额肌、鼻肌、口轮匝肌、上眼轮匝肌及下眼轮匝肌等5块面肌的ENoG值及复合肌肉动作电位(CMAP)波幅,并采用House Brackmann分级系统(HBGS)对患儿的面神经功能进行评估,随访至完全恢复或至首诊后6个月,通过HBGS再次评估患儿的面神经功能。分析比较不同面肌的ENoG值在各年龄组(婴幼儿组、学龄前儿童组、学龄儿童组)及各预后组(完全恢复组、不完全恢复组)间的差异,以及与首诊HBGS评级的相关性。绘制受试者工作特征曲线并计算曲线下面积(AUC),以评估早期不同面肌的ENoG值对BP患儿预后的价值。结果首诊时患儿各部位ENoG值越低,则对应的首诊HBGS评级越高(P<0.05);鼻肌、上眼轮匝肌及下眼轮匝肌表现更显著(P<0.01)。首诊时的鼻肌、上眼轮匝肌及下眼轮匝肌的ENoG值显示,完全恢复组的秩平均值高于不完全恢复组(P<0.05);首诊时鼻肌、上眼轮匝肌及下眼轮匝肌的ENoG值可用于评估BP患儿的预后,AUC值分别为0.732、0.695及0.796(P<0.05);将上眼轮匝肌与鼻肌ENoG值联合、上眼轮匝肌与下眼轮匝肌ENoG值联合、下眼轮匝肌与鼻肌ENoG值联合,准确性进一步提升,AUC分别为0.740、0.799及0.806(P<0.01);首诊HBGSⅡ~Ⅲ级患儿的预后明显好于Ⅳ~Ⅴ级患儿(P<0.01)。结论BP发病初期鼻肌、上眼轮匝肌及下眼轮匝肌的ENoG值与HBGS评级一样可反映患儿病情的严重程度,较低的ENoG值提示BP可能恢复不完全,增加ENoG面肌检测部位可提高BP患儿预后评估的准确性。

不同频次针刺对恢复期贝尔氏面瘫疗效的影响

目的 观察每日针刺1次与隔日针刺1次治疗恢复期贝尔氏面瘫(Bell’s palsy, BP)的临床疗效。方法 将184例恢复期BP患者随机分为A组和B组,每组92例。两组均接受相同的基础治疗和针刺治疗,A组每次针刺1次,B组隔日针刺1次。治疗4周后,观察两组治疗前后Sunnybrook(多伦多)面神经评定系统评分、House-Brackmann(H-B)面神经功能评级及面部残疾指数(facial disability index, FDI)量表各项评分[躯体功能(facial disability index physical function, FDIp)评分及社会生活功能(facial disability index social function, FDIs)评分]的变化情况,评定两组临床疗效。结果 A组治愈率明显高于B组,差异具有统计学意义(P<0.05)。两组总有效率比较,差异则无统计学意义(P>0.05)。两组治疗后Sunnybrook面神经评定系统评分及FDIp评分均较同组治疗前显著升高,FDIs评分均显著下降,H-B面神经功能评级均显著改善,差异均具有统计学意义(P<0.05)。A组治疗后Sunnybrook面神经评定系统评分、H-B面神经功能评级及FDI量表各项评分与B组比较,差异均具有统计学意义(P<0.05)。两组治疗前后Sunnybrook面神经评定系统评分及FDI量表各项评分的差值比较,差异均具有统计学意义(P<0.05)。结论 在基础治疗的基础上,针刺能有效改善恢复期BP患者临床症状,提高其生活质量,且每日针刺1次较隔日针刺1次疗效显著。

电针结合化风丹综合治疗特发性面神经麻痹临床观察

目的观察电针结合化风丹治疗特发性面神经麻痹的临床效果。方法将97例特发性面神经麻痹患者随机分为对照组48例与观察组49例。两组均采用基础治疗及电针疗法,观察组加用化风丹口服。在治疗前、治疗4周、8周时,通过House-Brackman(H-B)面神经功能分级系统和改良后的面神经功能评分系统评价患者的恢复情况。结果治疗后,两组患者在治疗各时间点的H-B面神经功能分级比较差异有统计学意义(P<0.05)。治疗后,各时间点面神经功能评分均较上一时间点有所降低,相邻两时间点之间的面神经功能评分差异有统计学意义(P<0.05)。面神经功能的评分方面,治疗后各时间点观察组均低于对照组,差异有统计学意义(P<0.05)。治疗4周及8周两组总有效率差异无统计学意义(P>0.05),两组显愈率差异有统计学意义(P<0.05)。结论电针结合化风丹综合治疗和单纯电针治疗对特发性面神经麻痹的恢复都有显著的疗效,电针与化风丹的联合应用能使患者的面神经功能更快恢复。

Facial reanimation with interposition nerve graft or masseter nerve transfer:a comparative retrospective study

Both interposition nerve grafts and masseter nerve transfers have been successfully used for facial reanimation after irreversible injuries to the cranial portion of the facial nerve.However,no comparative study of these two procedures has yet been reported.In this two-site,twoarm,retrospective case review study,32 patients were included.Of these,17 patients(eight men and nine women,mean age 42.1 years)underwent interposition nerve graft after tumor extirpation or trauma between 2003 and 2006 in the Ear Institute,School of Medicine,Shanghai Jiao Tong University,China,and 15 patients(six men and nine women,mean age 40.6 years)underwent masseter-to-facial nerve transfer after tumor extirpation or trauma between November 2010 and February 2016 in Shanghai Ninth People's Hospital,China.More patients achieved House-Brackmann III recovery after masseter nerve repair than interposition nerve graft repair(15/15 vs.12/17).The mean oral commissure excursion ratio was also higher in patients who underwent masseter nerve transfer than in patients subjected to an interposition nerve graft.These findings suggest that masseter nerve transfer results in strong oral commissure excursion,avoiding obvious synkinesis,while an interposition nerve graft provides better resting symmetry.This study was approved by the Institutional Ethics Committee,Shanghai Ninth People's Hospital,China(approval No.SH9 H-2019-T332-1)on December 12,2019.