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

Abstract

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. 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 deqi sensation. Acupuncture points used were points on the affected side and several points on both sides. 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. Acupuncture should be considered as one of the therapeutic tools for treating iatrogenic facial nerve paralysis.