Facial Nerve Damage in Bell’s Palsy according to When Korean Medical Treatment was Started: A Retrospective Study

Ji Eun Choi; Min Soo Kwon; Jung Hwan Kim; Dae Hyun Jo; Ji Sun Han; Hee Jin Jo; Ji Hye Kim; Hyun Ho Kim; Jung Won Kang; Dong Woo Nam

doi:10.13045/acupunct.2016016

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

Original Article

Acupuncture 2016; 33(2): 51-60.

DOI: https://doi.org/10.13045/acupunct.2016016

Facial Nerve Damage in Bell’s Palsy according to When Korean Medical Treatment was Started: A Retrospective Study

Ji Eun Choi¹, Min Soo Kwon¹, Jung Hwan Kim¹, Dae Hyun Jo¹, Ji Sun Han¹, Hee Jin Jo¹, Ji Hye Kim¹, Hyun Ho Kim², Jung Won Kang¹, Dong Woo Nam^1,^*

¹Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University

²Department of Biofunctional Medicine & Diagnostics, College of Korean Medicine, Kyung Hee University

^*Corresponding author: Department of Acupuncture & Moxibustion Medicine, Kyung Hee University Korean Medicine Hospital, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-872, Republic of Korea,
Tel: +82-2-958-1827, E-mail: hanisanam@hanmail.net

Received May 10, 2016 Revised June 02, 2016 Accepted June 07, 2016

See the Original "".

Abstract

Objectives:

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.

Methods:

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.

Results:

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.

Conclusion:

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.

Key Words: Bell’s palsy; Electromyography; Facial Nerve Damage; Early Korean Medical Treatment.

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 (0.916)	5.61 (0.892)	13.49 (2.544)
Gender^*	male	109	163	88	0.058
Gender^*	female	197	161	103	0.058

Age^†		49.8 (13.991)	48.88 (15.29)	49.74 (16.12)	0.703

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

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 (1.374)	14.07 (1.422)	15.91 (1.404)

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	59.69^a (57.00, 62.37), (51)	60.94^a (58.29, 63.58), (51)	84.76^b (82.36, 87.15), (26)
Oculi branch	62.66^a (60.30, 65.02), (0)	63.62^a (61.43, 65.82), (0)	85.19^b (83.29, 87.10), (0)
Nasal branch	63.11^a (60.85, 65.36), (0)	64.81^a (62.60, 67.02), (0)	86.17^b (84.31, 88.03), (0)
Oris branch	72.39^a (70.06, 74.72), (0)	76.20^b (74.14, 78.25), (0)	93.76^c (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.

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