Effectiveness of East-West collaborative hospital treatment on the prognosis of Bell’s palsy: A retrospective study

Article information

Acupunct. 2015;32(4):167-175
1Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University
*Corresponding author: Department of Acupuncture & Moxibustion Medicine, Kyung Hee University Korean Medicine Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul 134-727, Republic of Korea, Tel: +82-2-440-6224, E-mail: byhacu@khu.ac.kr
Received 2015 November 10; Revised 2015 December 01; Accepted 2015 December 04.

Abstract

Objectives:

This study was performed to confirm the effectiveness of East-West collaborative hospital treatment on the prognosis of Bell’s palsy.

Methods:

We screened patients who visited the Facial Palsy Center in Kyung Hee University Korean Medicine Hospital at Gangdong between June 2006 and June 2014 by inclusion/exclusion criteria We reviewed the medical records of 270 patients, including demographics and results of electromyography. We tried to compare the recovery rate of Bell’s palsy in the medical records with that of the previous study by calculating the odds ratio after 2, 3 and 6 months from the onset.

Results:

The odds ratio between our data and that from the previous study after 6 months from the onset was 4 899. Additionally, the odds ratios after 2 and 3 months from the onset were 1.471 and 2.054, respectively. All the odds ratios showed statistical significance.

Conclusions:

East-West collaborative hospital treatment showed significant effectiveness on the prognosis of Bell’s palsy.

Fig. 1

Flow chart

Fig. 2

Age distribution of patients with Bell’s palsy

Fig. 3

Onset distribution of patients with Bell’s palsy

Fig. 4

Distribution of EMG values in patients with Bell’s palsy

House-Brackmann grading system

Peitersen grading system

Number of patients with Bell’s palsy according to EMG values

Odds Ratio (OR)

References

1. Korean Acupuncture & Moxibustion Medicine Society. Acupuncture and Moxibustion Gyeonggi: Jipmoondang; 2008. p. 186–90.
2. Finsterer J. Management of peripheral facial nerve palsy. Eur Arch Otorhinolaryngol 2008;265(7):743–52.
3. Peitersen E. Bell’s palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol 2002;122(7):4–30.
4. Yamamoto E, Nishimura H, Hirono Y. Occurrence of sequelae in Bell’s palsy. Acta Otolaryngol 1987;104(Suppl 446):S93–6.
5. Valls-Solè J. Facial palsy, postparalytic facial syndrome, and hemifacial spasm. Mov Disord 2002;17(Suppl 2):S49–52.
6. Hato N, Yamada H, Kohno H, et al. Valacyclovir and prednisolone treatment for Bell’s palsy: a multicenter, randomized, placebo-controlled study. Otol Neurotol 2007;28(3):408–13.
7. Kwon NH, Shin YJ, Kim CY, et al. Comparative Clinical Study between Oriental Medical and Oriental-Western Medical Treatment on Bell’s Palsy. The Acupuncture 2008;25(3):19–28.
8. Park IB, Kim SW, Lee CW, et al. Comparative Clinical Study between Oriental Medicine and Oriental-Western Medicine Treatment on Bell’s palsy. The Acupuncture 2004;21(5):191–203.
9. Kim JH, Song JJ, Hong SU. A clinical study of oriental-western medicine treatment on facial nerve paralysis. J Korean Med Ophthalmol Otolaryngol Dermatol 2009;22(1):148–56.
10. Slavkin HC. The significance of a human smile: observations on Bell’s palsy. J Am Dent Assoc 1999;130(2):269–72.
11. Heo J. Donguibogam Seoul: Bubin Publishers; 2005. p. 688–9.
12. De R JA, Brennan PA, Martens E. Antiviral agents convey added benefit over steroids alone in Bell’ s palsy; decompression should be considered in patients who are not covering. J Laryngol Otol 2015;129(4):300–6.
13. Lee JW, Kwon SA, Kin MJ, et al. A Study of Facial Palsy Sequelae and Evaluating Scale. The Acupuncture 2011;28(2):75–87.
14. Chung JH, Lee SK, Kim SH, Yeo SG, Park MS, Byun JY. Neurotological parameters and prognosis of Bell’s palsy patients. Audiol Neurootol 2015;20(2):117–21.
15. Lee HY, Byun JY, Park MS, Yeo SG. Steroid-antiviral treatment improves the recovery rate in patietns with severe Bell’s palsy. Am J Med 2013;126(4):336–41.
16. Byun H, Cho YS, Jang JY, et al. Value of electroneurography as a prognostic indicator for recovery in acute severe inflammatory facial paralysis: a prospective study of Bell’s palsy and Ramsay Hunt syndrome. Laryngoscope 2013;123(10):2526–32.

Article information Continued

Fig. 1

Flow chart

Fig. 2

Age distribution of patients with Bell’s palsy

Fig. 3

Onset distribution of patients with Bell’s palsy

Fig. 4

Distribution of EMG values in patients with Bell’s palsy

Table 1

House-Brackmann grading system

Grade Description Characteristics
I Normal Normal facial function all areas
II Mild dysfunction Gross: Slight weakness noticeable on close inspection on close inspection may have very slight synkinesis
At rest: normal symmetry and tone
Motion
  Forehead: motion is moderate to good function
  Eye: complete closure with minimal effort
  Mouth: slight asymmetry
III Moderate dysfunction Gross: obvious but not disfiguring difference between both the 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
At rest: asymmetry
Motion
  Forehead: none
  Eye: incomplete closure
  Mouth: slight movement
VI Total paralysis No movement

Table 2

Peitersen grading system

Grade Degree of palsy Description of palsy
0 None Normal function
I Slight Only visible when patient grimaces
II Moderate Visible with small facial movements
III Severe Function just visible
IV Complete No visible

Table 3

Number of patients with Bell’s palsy according to EMG values

Recovery EMG(%) p-value
<50 50~60 60~70 70~80 80~90 90~95 ≥95
After 2 months from
the onset for
HB grade 1
40/45
(88.9 %)
30/33
(90.9 %)
42/51
(82.4 %)
34/40
(85.0 %)
31/67
(46.3 %)
4/24
(16.7 %)
0/10
(0.0 %)
0.000*
After 3 months from
the onset for
HB grade 1
43/45
(95.6 %)
31/33
(93.9 %)
47/51
(92.2 %)
39/40
(97.5 %)
45/67
(67.2 %)
7/24
(29.2 %)
0/10
(0.0 %)
0.000*
After 6 months from
the onset for
HB grade 1
44/45
(97.8 %)
32/33
(97.0 %)
51/51
(100.0 %)
40/40
(100.0 %)
56/63
(88.9 %)
11/17
(64.7 %)
2/7
(28.6 %)
0.000*
*

p-value <0.001 by Linear by linear association

Table 4

Odds Ratio (OR)

Recovery OR 95 % confidence interval p-value
lower limit upper limit
2 months / HB grade 1 1.471 1.122 1.930 p<0.01*
3 months / HB grade 1 2.054 1.511 2.792 p<0.001**
6 months / HB grade 1 4.899 3.067 7.824 p<0.001**
*,**

by chi-square test