Analysis for the Idiopathic Facial Palsy Inpatients According to Distribution of Sasang Constitution, Hyungsang Classification and Assessment Tools

Article information

J Korean Acupunct Moxib Soc. 2013;30(4):55-68
Publication date (electronic) : 2013 September 20
doi : https://doi.org/10.13045/acupunct.2013022
1Department of Acupuncture & Moxibution Meridian & Acupoint, College of Oriental Medicine, Dong-Eui University
2Research Institute of Oriental Medicine, Dong-Eui University
*Corresponding author : Department of Acupuncture and Moxibution Medicine, Dong-eui Oriental University Hospital, 62, Yangjeong-ro, Busanjin-gu, Busan, 614-851, Republic of Korea, Tel : +82-51-850-8612 E-mail : kmdkch@deu.ac.kr
Received 2013 July 31; Revised 2013 August 28; Accepted 2013 August 28.

Abstract

Objectives :

The purpose of this study is to analyze the distribution, relationship, prognosis and improvement score of idiopathic facial palsy inpatients according to constitutional differentiation ; Sasang constition, Hyungsang classification, Sasang constition combined with Hyungsang classification.

Methods :

A study was done on 102 patients who were diagnosed and treated as idiopathic facial palsy from April 2012 to Nomember 2012 at the Department of Acupuncture and Moxibution Medicine, Dong-eui Oriental University Hospital. Medical records of inpatinets who underwent facial ENoG, NET test were analyzed. Changes of HBGS grade and Yanagihara’s score were also evaluated. We classified inpaients acording to Sasang constitution by consulting to Department of Sasang constitutinal medicine, and to Hyungsang classification(Dam-body, Bangkwang-body) by measuring under medical system of 3D facial shapes(RS-400FL). The constitutional differentiation and general characteristics were initially analyzed, and valuse on ENoG, NET were correlated with constitutinal differentiation. Results of HBGS and Yanagihara’s score were also correlated with constitutinal differentiation.

Results :

  1. Each 39.2 percent of idiopathic facial palsy inpatients were the Taeeumin and Soyangin, 21.6 percent were the Soeumin.

  2. 75.5 percent of idiopathic facial palsy inpatients were the Bangkwang-body, 24.5 percent were the Dam-body.

  3. 34.3 percent of idiopathic facial palsy inpatinets were the Taeeum-Bangkwang, 21.6 percent were the Soyang-Bangkwang, 19.6 percent were the Soeum-Bangkwang, 17.6 percent were the Soyang-Dam, 4.9 percent were the Taeem-Dam, 2 percent were the Soeum-Dam.

  4. By sex, the each ratio of Taeeumin, Soeumin, Bangkwang-body, Taeeum-Bangkwang, Soeum-Bangkwang, Soyang-Bangkwang was higher in female, that of Dam-body, Taeeum-Dam, Soyang-Dam was higher in male.

  5. By relations between Sasang constitution and Hyungsang classification, the each ratio of Taeeumin and Soeumin was higher in Bangkwang-body.

  6. By values on ENoG and NET, evaluations of HBGS’s grade and Yanagihara’s score, there were no significant difference.

Conclusions :

In idiopathic facial palsy inpatients, the proportion of Taeeum and Soyang among the Sasang constitution was higher, that of Dam among the Hyungsang classification was higher, that of Taeeum-Bangkwang among the Sasang combined with Hyungsang was the highest. It would seem that Bangkwang-body, female were closely related to Taeeumin, Soeumin. Also, Dam-body were closely related to male. But when comparing groups, there was no statistically significant difference in prognosis and improvement.

House-Brackmann Facial Palsy Grade System

Yanagihara’s Unweighted Grading System

General Characteristics of Participants

Characteristics of Participants by Sasang Constitution

Characteristics of Participants by Hyungsang Classification

Characteristics of Participants by Sasang Constitution Combined with Hyungsang Classification

Comparison of ENoG and NET in Sasang Constitution

Comparison of ENoG and NET in Hyungsang Classification

Comparison of ENoG and NET in Sasang Constitution Combined with Hyungsang Classification

Comparison of HBGS Grade and Y-score in Sasang Constitution

Comparison of HBGS Grade and Y-score in Hyungsang Classification

Comparison of HBGS Grade and Y-score in Sasang Constitution Combined with Hyungsang Classification

References

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Article information Continued

Table 1.

House-Brackmann Facial Palsy Grade System

Grade Characteristics
I. Normal Normal facial function in all areas
II. Mild dysfunction Gross
  • Slight weakness noticeable on close inspection

  • May have slight synkinesis

  • At rest, normal symmetry and tone


Motion
  • Forehead : moderate-to-good function

  • Eye : complete closure with minimal effort

  • Mouth : slight asymmetry

III. Moderate dysfunction Gross
  • Obvious but not disfiguring difference between the two sides

  • Noticeable but not severe synkinesis, contracture, or hemifacial spasm

  • At rest, normal symmetry and tone


Motion
  • Forehead : slight-to-moderate movement

  • Eye : complete closure with effort

  • Mouth : slightly weak with maximum effort

IV. Moderately severe dysfunction Gross
  • Obvious weakness and/or disfiguring asymmetry

  • At rest, normal symmetry and tone


Motion
  • Forehead : none

  • Eye : incomplete closure

  • Mouth : asymmetric with maximum effort

V. Severe dysfunction Gross
  • Only barely perceptible motion

  • At rest, asymmetry


Motion
  • Forehead : none

  • Eye : incomplete closure

  • Mouth : slight movement

VI. Total paralysis No movement

1985. American Academy of Otolaryngology-Head and Neck Surgery(AAO-HNS).

Table 2.

Yanagihara’s Unweighted Grading System

Scale of five rating
At rest 0 1 2 3 4
Wrinkle forehead 0 1 2 3 4
Blink 0 1 2 3 4
Closure of eye lightly 0 1 2 3 4
Closure of eye tightly 0 1 2 3 4
Closure of eye involved side only 0 1 2 3 4
Wrinkle nose 0 1 2 3 4
Whistle 0 1 2 3 4
Grin 0 1 2 3 4
Depress lower lip 0 1 2 3 4

5-point system : 4-normal, 3-slight, 2-moderate, 1-severe, 0-total.

Table 3.

General Characteristics of Participants

Number(percentage)
Sasang constitution Taeeumin / Soyangin / Soeumin 40(39.2) / 40(39.2) / 22(21.6)
Hyungsang Classification Bangkwang-body / Dam-body 77(75.5) /25(24.5)
Sasang Constitution Combined with Hyungsang Classification Taeeumin-Bangkwang 35(34.3)
Taeeumin-Dam 5(4.9)
Soyangin-Bangkwang 22(21.6)
Soyangin-Dam 18(17.6)
Soeumin-Bangkwang 20(19.6)
Soeumin-Dam 2(2.0)
Sex Male / female 35(34.3) / 67(65.7)
Affected part Left / right 61(59.8) / 41(40.2)
Total 102(100)

Table 4.

Characteristics of Participants by Sasang Constitution

Taeeumin, N(%) Soyangin, N(%) Soeumin, N(%) p-value
Sex(M/F) 12(30.0)/28(70.0) 21(52.5) / 19(47.5) 2(9.1) / 20(90.9) 0.002*
Affected part(L/R) 21(52.5)/19(47.5) 27(67.5) / 13(32.5) 13(59.1) / 9(40.9) 0.391
Age(mean±/SD) 48.70±14.24 53.03±16.10 47.45±13.40 0.538**
*:

using Pearson’s Chi-square test, p0.05.

**:

using one-way ANOVA, p>0.05.

Table 5.

Characteristics of Participants by Hyungsang Classification

Bangkwang-body, (%) Dam-body, N(%) p-value
Sex(M/F) 15(19.5) / 62(80.5) 20(80.0) / 5(20.0) 0.000*
Affected part(L/R) 43(55.8) / 34(44.2) 18(72.0) / 7(28.0) 0.152
Age(mean±/SD) 49.29±14.70 52.72±15.45 0.918**
*:

using Pearson’s Chi-square test, p0.05.

**:

using independent-samples t-test, p>0.05.

Table 6.

Characteristics of Participants by Sasang Constitution Combined with Hyungsang Classification

Participants Sex(M/F) Affected part(L/R) Age(mean±/SD)
Taeeumin-Bangkwang, N(%) 35(34.3) 7(20.0) / 28(80.0) 19(54.3) / 16(45.7) 49.57±14.90
Taeeumin-Dam, N(%) 5(4.9) 5(100.0) / 0(0.0) 2(40.0) / 3(60) 42.60±6.03
Soyangin-Bangkwang, N(%) 22(21.6) 7(31.8) / 15(68.2) 13(59.1) / 9(40.9) 51.18±15.45
Soyangin-Dam, N(%) 18(17.6) 14(77.8) / 4(22.2) 14(77.8) / 4(22.2) 55.28±17.03
Soeumin-Bangkwang, N(%) 20(19.6) 1(5.0) / 19(95.0) 11(55.0) / 9(45.0) 46.70±13.83
Soeumin-Dam, N(%) 2(2.0) 1(50.0) / 1(50.0) 2(100.0) / 1(0.0%) 55.00±2.83
p-value 0.001* 0.000* 0.390 0.438**
*:

using Pearson’s Chi-square test, p<0.05.

**:

using one-way ANOVA, p>0.05.

Table 7.

Comparison of ENoG and NET in Sasang Constitution

ENoG NET(D) forehead NET(D) eye NET(D) nose NET(D) lip
Taeeumin 45.31±18.45 1.05±1.65 0.95±1.31 1.14±1.93 1.36±1.76
Soyangin 48.48±24.70 1.32±1.69 1.31±1.50 1.51±1.87 1.15±0.89
Soeumin 51.75±20.72 1.40±1.40 1.27±1.09 1.52±1.29 1.46±1.27
p-value 0.548 0.690 0.467 0.637 0.793

Values are number or mean±SD.

NET(D) : difference of abnormal and normal NET.

Using Kruskal-Wallis test, p<0.05.

Table 8.

Comparison of ENoG and NET in Hyungsang Classification

ENoG NET(D) forehead NET(D) eye NET(D) nose NET(D) lip
Bangkwang-body 48.19±20.67 1.28±1.73 1.14±1.42 1.40±1.93 1.30±1.45
Dam-body 47.00±24.35 1.08±1.21 1.21±1.13 1.27±1.33 1.28±1.10
Z −0.342 −0.430 −0.180 −0.401 −0.063
p-value 0.732 0.667 0.857 0.688 0.950

Values are Number or mean±SD.

NET(D) : difference of abnormal and normal NET.

Using Mann-Whitney U test, p<0.05.

Table 9.

Comparison of ENoG and NET in Sasang Constitution Combined with Hyungsang Classification

ENoG NET(D) forehead NET(D) eye NET(D) nose NET(D) lip
Taeeumin-Bangkwang 45.15±17.93 1.19±1.73 0.96±1.38 1.24±2.05 1.48±1.80
Taeeumin-Dam 46.40±24.03 0.14±0.42 0.88±0.75 0.50±0.62 0.54±1.30
Soyangin-Bangkwang 50.86±25.51 1.36±1.28 1.31±1.23 1.52±1.45 1.44±0.89
Soyangin-Dam 45.56±24.10 1.36±1.28 1.31±1.23 1.52±1.45 1.44±0.89
Soeumin-Bangkwang 50.67±19.28 1.44±1.46 1.27±1.09 1.58±1.34 1.43±1.23
Soeumin-Dam 61.50±40.31 0.90±0.71 1.20±1.41 1.00±0.71 1.70±2.26
p-value 0.877 0.252 0.879 0.477 0.235

Values are number or mean±SD.

NET(D) : difference of abnormal and normal NET.

Using Kruskal-Wallis test, p<0.05.

Table 10.

Comparison of HBGS Grade and Y-score in Sasang Constitution

Taeeumin Soyangin Soeumin p-value
H1 3.75±0.44 3.65±0.53 3.73±0.56 0.606
Y1 16.80±6.17 18.20±6.60 17.50±7.72 0.605
H21 −0.03±0.29 0.03±0.28 −0.48±0.22 0.540
H31 −0.39±0.60 −0.45±0.60 −0.62±0.50 0.250
H41 −1.25±0.60 −1.20±0.72 −1.29±0.72 0.745
Y21 1.89±3.45 2.03±3.65 3.14±3.20 0.293
Y31 6.83±4.17 7.73±5.39 7.73±5.39 0.358
Y41 13.39±4.59 13.08±5.67 14.86±5.78 0.575

Values are number or mean±SD. Using Kruskal-Wallis test, p<0.05.

H1 : HBGS grade of admission date.

Y1 : Y-score of admission date.

H21 : the changes of HBGS during assessment date of ENoG - admission date.

H31 : the changes of HBGS during 2 weeks after onset - admission date.

H41 : the changes of HBGS during 4 weeks after onset - admission date.

Y21: the changes of Y-score during assessment date of ENoG - admission date.

Y31: the changes of Y-score during 2 weeks after onset - admission date.

Y41: the changes of Y-score during 4 weeks after onset - admission date.

Table 11.

Comparison of HBGS Grade and Y-score in Hyungsang Classification

Bangkwang-body Dam-body Z p-value
H1 3.74±0.50 3.60±0.50 −1.185 0.236
Y1 17.39±6.76 17.84±6.45 −0.316 0.752
H21 −0.01±0.27 0.00±0.29 −0.221 0.825
H31 −0.49±0.60 −0.40±0.50 −0.565 0.572
H41 −1.28±0.70 −1.12±0.36 −0.923 0.356
Y21 2.08±3.26 2.60±4.11 −0.324 0.746
Y31 8.12±5.72 8.12±5.72 −0.277 0.782
Y41 13.60±5.10 13.52±5.97 −0.103 0.918

Values are number or meam±SD. Using Mann-Whitney U test, p<0.05

H1 : HBGS grade of admission date.

Y1 : Y-score of admission date.

H21 : the changes of HBGS during Assessment date of ENoG - admission date.

H31 : the changes of HBGS during 2 weeks after onset - admission date.

H41 : the changes of HBGS during 4 weeks after onset - admission date.

Y21: the changes of Y-score during Assessment date of ENoG - admission date.

Y31: the changes of Y-score during 2 weeks after onset - admission date.

Y41: the changes of Y-score during 4 weeks after onset - admission date.

Table 12.

Comparison of HBGS Grade and Y-score in Sasang Constitution Combined with Hyungsang Classification

Taeeumin-Bangkwang Taeeumin-Dam Soyangin-Bangkwang Soyangin-Dam Soeumin-Bangkwang Soeumin-Dam p-value
H1 3.77±0.43 3.60±0.55 3.72±0.55 3.56±0.51 3.70±0.57 4.00±0.00 0.644
Y1 16.63±5.99 18.00±8.00 18.27±6.80 18.11±6.53 17.75±8.07 15.00±0.00 0.947
H21 −0.03±0.31 0.00±0.00 0.00±0.31 0.06±0.24 0.00±0.00 −0.50±0.71 0.157
H31 −0.39±0.62 −0.40±0.55 −0.50±0.67 −0.39±0.50 −0.63±0.50 −0.50±0.71 0.697
H41 −1.23±0.62 −1.40±0.55 −1.36±0.79 −1.00±0.59 −1.26±0.73 −1.50±0.71 0.607
Y21 2.06±3.41 0.80±3.96 2.61±3.99 2.61±3.99 2.74±2.92 7.00±4.24 0.190
Y31 6.90±3.79 6.40±6.66 7.32±5.32 8.22±5.59 8.42±4.34 11.50±6.36 0.709
Y41 13.39±4.34 13.40±6.54 13.00±5.47 13.17±6.07 14.63±5.90 17.00±5.66 0.908

Values are number or mean±SD. Using Kruskal-Wallis test, p<0.05.

H1 : HBGS grade of admission date.

Y1 : Y-Score of admission date.

H21 : the changes of HBGS during assessment date of ENoG - admission date.

H31 : the changes of HBGS during 2 weeks after onset - admission date.

H41 : the changes of HBGS during 4 weeks after onset - admission date.

Y21 : the changes of Y-score during assessment date of ENoG - admission date.

Y31 : the changes of Y-score during 2 weeks after onset - admission date.

Y41 : the changes of Y-score during 4 weeks after onset - admission date.