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基于House-Brackmann面神经分级系统运用针刺疗法改善医源性面神经麻痹:1例病例报告

Improved Iatrogenic Facial Nerve Paralysis Based on House-Brackmann Facial Nerve Grading System by Using Acupuncture Therapy: A Case Report.

作者信息

Hartanto Andry, Supriyana Dwi Surya, Simadibrata Christina

机构信息

Medical Acupuncture, Manyar Medical Centre Hospital Surabaya, Surabaya, Indonesia.

Medical Acupuncture Division, UNS Teaching Hospital, Faculty of Medicine Universitas Sebelas Maret, Surakarta, Central Java, Indonesia.

出版信息

Med Acupunct. 2022 Oct 1;34(5):337-343. doi: 10.1089/acu.2021.0042. Epub 2022 Oct 17.

Abstract

BACKGROUND

Iatrogenic facial nerve paralysis is often caused by surgical procedures on temporomandibular joint due to temporomandibular disorder. It can affect the quality of life of the patient due to the facial nerve's importance in communication and expressions.

CASE

We hereby report a case of a 22-year-old man with right facial nerve paralysis after he had arthroplasty surgery. He received Mefenamic Acid 3 × 500 mg (if necessary) and Mecobalamin 1 × 500 mg. He was treated with manual acupuncture therapy for 3 times a week with 30 minutes of each session until he has reached the sensation. Acupuncture points used were points on the affected side and several points on both sides.

RESULTS

The patient underwent acupuncture treatments for 28 sessions in 4.5 months. On the eighth session, the patient had no visible right lagophthalmos. The patients' jaws could open normally after the 12th session, and at the end of the sessions (28th) the patient could raise and lower his right eyebrow perfectly. We found that patient's facial nerve function was improved to normal based on House-Brackmann facial nerve grading system. The nerve conduction velocity and electromyography test results also improved.

CONCLUSIONS

Acupuncture should be considered as one of the therapeutic tools for treating iatrogenic facial nerve paralysis.

摘要

背景

医源性面神经麻痹常由颞下颌关节疾病的颞下颌关节手术引起。由于面神经在沟通和表情方面的重要性,它会影响患者的生活质量。

病例

我们在此报告一例22岁男性在进行关节成形术后出现右侧面神经麻痹的病例。他服用了甲芬那酸3×500毫克(必要时)和甲钴胺1×500毫克。他接受了每周3次的手动针刺治疗,每次治疗30分钟,直至恢复感觉。使用的穴位为患侧穴位及双侧的几个穴位。

结果

患者在4.5个月内接受了28次针刺治疗。在第8次治疗时,患者右侧无明显兔眼。第12次治疗后患者下颌可正常张开,在治疗结束时(第28次)患者右侧眉毛可完美地抬起和降下。根据House-Brackmann面神经分级系统,我们发现患者的面神经功能恢复正常。神经传导速度和肌电图测试结果也有所改善。

结论

针刺应被视为治疗医源性面神经麻痹的治疗手段之一。

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