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J Acupunct Res > Volume 33(2); 2016 > Article
Choi, Kwon, Kim, Jo, Han, Jo, Kim, Kim, Kang, and Nam: Facial Nerve Damage in Bell’s Palsy according to When Korean Medical Treatment was Started: A Retrospective Study
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Although integrative Korean medical treatments have been suggested to be effective for treating Bell’s palsy, the effect of Korean medical treatment according to when treatment was started is unknown in the clinical field. Therefore, this study was conducted to determine the results of treating Bell’s palsy according to different starting points of integrative Korean medical treatments.


We screened patients who visited the Facial Palsy Center at Kyung Hee University Hospital for Korean and Western combined medical treatment from March 2011 to February 2016. A total of 821 out of 2086 patients were studied, including their basic characteristics and results of an electromyography. Patients who started Korean medical treatment within 3 days of onset were placed in group A, within 9 days of onset in group B, and patients who started treatment after 10 days of onset were placed in group C. We tried to compare the level of facial nerve damage by electromyography between groups.


The patients in group C had the highest axonal loss rates in all branches(frontal, oculi, nasal, oris). The post hoc analyses revealed the difference of axonal loss rates between group A and B was not statistically significant. Only group C showed statistically higher axonal loss rates in all branches.


The study results showed that the patients who had delayed Korean medical treatments had a higher level of facial nerve damage by electromyography. According to the results of this study, early application of integrative Korean medical treatment is suggested.

Fig. 1
Flow chart
Fig. 2
Distribution of patients’ age
Fig. 3
Distribution of time to treatement from onset
Fig. 4
Box plots for axonal loss rate comparison among groups divided by days from onset until the first Korean Medicine treatment
A: 0~3 days; B: 4~9 days; C: more than 9 days; +: arithmetic mean; o: outliers.
Table 1
Basic Characteristics of Included Subjects
Group A (n=306) B (n=324) C (n=191) p-value
days from onset until KM treatment start 2.4
Gender* male 109 163 88 0.058
female 197 161 103

Age 49.8

Paralyzed side* left 152 174 104 0.497
right 154 150 87

H-B grade III 127 96 45 <0.001
IV 157 171 113
V 22 57 33

Diabetes* 54 57 39 0.681

Hypertension* 77 71 51 0.422

Days from onset until EMG examination 13.7

KM: Korean Medicine EMG: Electromyography.

Data are presented as number of patients or mean(standard deviation).

* non-significant dependency among groups by chi-squre test.

non-significant dependency among groups by ANOVA test.

significant dependency among groups by chi-squre test.

Table 2
EMG Axonal Loss Rate Comparison among Groups
A (n=306) B (n=324) C (n=191)
Frontal branch 59.69a
(57.00, 62.37), (51)
(58.29, 63.58), (51)
(82.36, 87.15), (26)
Oculi branch 62.66a
(60.30, 65.02), (0)
(61.43, 65.82), (0)
(83.29, 87.10), (0)
Nasal branch 63.11a
(60.85, 65.36), (0)
(62.60, 67.02), (0)
(84.31, 88.03), (0)
Oris branch 72.39a
(70.06, 74.72), (0)
(74.14, 78.25), (0)
(92.33, 95.20), (0)

Data are presented as mean (95 % confidence interval), (number of missing values).

abc homogeneous subsets by Dunnett T3 method for non-equal variance assumption.

All branches have statistically significant difference among groups by ANOVA test with all p-values less than 0.001. Groups are divided by days from onset until the first Korean Medicine treatment. A: 0~3 days; B: 4~9 days; C: more than 9 days.

VI. Reference

1. Donika KP, Kerry HL. Bell palsy: Clinical examination and management. Cleve Clin J Med. 2015;82(7):419–26.
crossref pmid
2. Sullivan FM, Swan IR, Donnan PT, et al. Early treatment with prednisolone or acyclovir in Bell’s palsy. N Engl J Med. 2007;357(16):1598–607.
crossref pmid
3. Morris AM, Deeks SL, Hill MD, et al. Annualized incidence and spectrum of illness from an outbreak investigation of Bell’s palsy. Neuroepidemiology. 2002;21(5):255–61.
crossref pmid
4. Baek BS, Park SP, Suh CK. Relationship between Prognosis and Serial Electrophysiologic Study in Bell’s Palsy. J Kor Neurol Ass. 1999;17(5):668–74.

5. Sung WS, Goo BH, Ryu HK, et al. Study on the Validity of Electromyography(EMG) And Early performed Electroneurography(ENoG) as Predicting Factor for Facial Palsy-Based on Collaborative Treatment between Korean and Western Medicine. The Acupuncture. 2013;30(4):115–23.
6. Gronseth Gary S, Padua Remia. Evidence-Based Guideline Update: Steroids and Antivirals for Bell Palsy: Report of the Guideline Development Subcommittee of The American Academy of Neurology. Neurology. 2012;79(22):2209–13.
crossref pmid
7. Ahmed A. When is facial paralysis Bell palsy? Current diagnosis and treatment. Cleveland Clinic journal of medicine. 2005;72(5):398–405.
crossref pmid
8. Fu L, Bundy C, Sadiq SA. Psychological distress in people with disfigurement from facial palsy. Eye. 2011;25(10):1322–6.
crossref pmid pmc
9. Devriese PP, Schumacher T, Scheide A, et al. Prognosis and recovery of Bell’s palsy. A survey of about 1000 patients Incidence. Clin Otolaryngol Allied Sci. 1999;15(1):1974–83.

10. Holland NJ, Weiner GM. Recent developments in Bell’s palsy. BMJ. 2004;329(7465):553–7.
crossref pmid pmc
11. Grosheva M, Wittekindt C, Guntinas-Lichius O. Prognostic Value of Electroneurography and Electromyography in Facial Palsy. Laryngoscope. 2008;118(3):394–7.
crossref pmid
12. Sittel C, Stennert E. Prognostic value of electromyography in acute peripheral facial nerve palsy. Otol Neurotol. 2001;22(1):100–4.
crossref pmid
13. Kasse CA, Cruz OL, Leonhardt FD, et al. The value of prognostic clinical data in Bell’s palsy. Rev Bras Otorrinolaringol. 2005;71(4):454–8.
14. Korean Acupuncture & Moxibustion Society. Acupuncture and Moxibustion. 2. Gyeonggi: Jipmoondang. 2008:186–90.

15. Kim PK, Sung WS, Goo BH, et al. Retrospective Study on Factors Influencing Facial Nerve Damage of Acute Peripheral Facial Palsy Patients: by Electromyography. The Acupuncture. 2013;30(5):155–67.
16. Axelsson S, Lindberg S, Stjernquist-Desatnik A, et al. Outcome of treatment with valacyclovir and prednisone in patients with Bell’s palsy. Ann Otol Rhinol Laryngol. 2003;112(3):197–201.
crossref pmid
17. Liang F, Li Y, Yu S, et al. A multicentral randomized control study on clinical acupuncture treatment of Bell’s palsy. J Tradit Chin Med. 2006;26(1):3–7.
18. Li Y, Liang FR, Yu SG, et al. Efficacy of acupuncture and moxibustion in treating Bell’s palsy: a multicenter randomized controlled trial in China. Chin Med J. 2004;117(10):1502–6.
19. Suk KH, Lee JH, Ryu SH, et al. Effectiveness of East-West collaborative hospital treatment on the prognosis of Bell’s palsy: A retrospective study. The Acupuncture. 2015;32(4):167–75.
20. de Almeida JR, Guyatt GH, Sud S, et al. Management of Bell palsy: clinical practice guideline. CMAJ. 2014;186(12):917–22.
crossref pmid pmc

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