Clinical Case Study of Facial Nerve Paralysis with Sensorineural Hearing Loss and Tinnitus Caused by Traumatic Temporal Bone Fracture

Article information

Acupunct. 2016;33(1):95-101
1Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Dong-Shin University
2Department of Ophthalmology, Otolaryngology & Dermatology Medicine, College of Korean Medicine, Dong-Shin University
3Department of Rehabilitation Medicine, College of Korean Medicine, Dong–Shin University
4Department of Nursing Service, Dong-Shin University Gwangju Hospital
*Corresponding author: Department of Acupuncture & Moxibustion Medicine, Gwangju Korean Medicine Hospital of Dong–Shin University, 141, Wolsan-ro, Nam-gu, Gwangju, 503-232, Republic of Korea, Tel: +82-62-350-7209, E-mail: nahonga@hanmail.net
Received 2015 November 14; Revised 2016 March 10; Accepted 2016 March 14.

Abstract

Objectives:

The aim of this report was to investigate the effects of Korean medical treatment on facial nerve paralysis with sensorineural hearing loss and tinnitus caused by traumatic temporal bone fracture

Methods:

We treated a patient with acupuncture, herbal medicine and physiotherapy. The effect of these treatments was evaluated by House-Brackmann facial grading scale, Yanagihara’s unweighted grading system and by Digital Infrared Thermographic Image.

Results:

After 21 days of Korean medical treatment, House-Brackmann facial grading scale changed from III to II and Yanagihara’s unweighted grading score increased from 14 to 27. Digital Infrared Thermographic Image also improved.

Conclusions:

These results suggest that Korean medical treatments were effective in treating facial nerve paralysis with sensorineural hearing loss and tinnitus caused by traumatic temporal bone fracture. We hope that a more efficient application of this treatment will be the result of clinical data accumulated in future studies.

Facial Nerve Grading Systems by House-Brackmann

Yanagihara’s unweighted grading system

Change of score by treatment-Yanagihara Score and House Brackmann Grade

Change of score by treatment - Digital Infrared Thermographic Image

References

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Article information Continued

Table 1

Facial Nerve Grading Systems by House-Brackmann

Grade Description Characteristics
I Normal Gross: slight weakness noticeable on close inspection may have very slight synkinesis
At rest: Normal symmetry and tone
II Mild dysfunction Motion: Forehead-Moderate to good function
Eye-Complete closure with minium effort
Mouth-Slight asymmetry
Gross: Obvious but not disfiguring difference between two sides, noticeable but severe synkinesis, contracture, and/or hemifacial spasm
At rest: Normal symmetry and tone
III Moderate dysfunction Motion: Forehead-Slight go moderate movement
Eye-Complete closure with effort
Mouth-Slight weak with maximum effort
Gross: Obvious weakness and/or disfiguring asymmetry
At rest: Normal symmetry and tone
IV Moderately severe dysfunction Motion: Forehead-None
Eye-Incomplete closure
Mouth-asymmetry with maximum effort
Gross: Only barely perceptible
At rest: asymmetry
V Severe dysfunction Motion: Forehead-None
Eye-Incomplete closure
Mouth-Slight movement
VI Total paralysis No movement

Table 2

Yanagihara’s unweighted grading system

Scale of five rating
At rest 0 1 2 3 4
Wrinkle forehead 0 1 2 3 4
Blink 0 1 2 3 4
Closure of eye lightly 0 1 2 3 4
Closure of eye tightly 0 1 2 3 4
Closure of eye involved side only 0 1 2 3 4
Wrinkle nose 0 1 2 3 4
Whistle 0 1 2 3 4
Grin 0 1 2 3 4
Depress lower lip 0 1 2 3 4

Table 3

Change of score by treatment-Yanagihara Score and House Brackmann Grade

6/02 6/05 6/08 6/11 6/15
At rest 3 3 3 3 3
Wrinkle forehead 1 2 1 2 2
Blink 1 1 2 3 3
Closure of eye lightly 2 3 2 3 4
Closure of eye tightly 2 2 3 3 3
Closure of eye involved side only 0 0 0 3 3
Wrinkle nose 1 1 2 2 2
Whistle 0 0 0 0 0
Grin 3 3 3 3 3
Depress lower lip 1 2 2 3 3
Y-S 14 17 18 25 27
H-B III III III II II
Tinnitus NRS 7 6 5 4 4

Table 4

Change of score by treatment - Digital Infrared Thermographic Image

2015.06.02 2015.06.15
Right Left ΔT Right Left ΔT
GB14 33.54 33.03 0.51 33.01 32.84 0.17
BL02 33.63 33.19 0.44 33.04 32.83 0.21
TE23 32.74 32.20 0.54 32.65 32.14 0.51
BL01 33.42 33.10 0.32 32.98 33.06 −0.08
ST02 32.61 32.08 0.53 32.41 32.17 0.24