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

Article information

Acupunct. 2016;33(2):51-60
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 2016 May 10; Revised 2016 June 02; Accepted 2016 June 07.

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.

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.

Basic Characteristics of Included Subjects

EMG Axonal Loss Rate Comparison among Groups

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Article information Continued

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
female 197 161 103

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

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