A Case Report on Facial Nerve Palsy after Tooth Extraction and Korean Medical Treatments

Article information

Acupunct. 2016;33(2):211-220
1Department of Acupuncture & Moxibustion, Pusan National University Korean Medicine Hospital
2Bon Dental Clinic
3Division of Clinical Medicine, School of Korean Medicine, Pusan National University
*Corresponding author: Division of Clinical Medicine, School of Korean Medicine, Pusan National University, 20 Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea, Tel: +82-55-360-5963, E-mail: ygy@pnu.edu
Received 2016 May 11; Revised 2016 June 07; Accepted 2016 June 11.



Facial nerve palsy is a rare but well-known complication that occurs after a tooth extraction. The paralysis follows the injection of a local anesthetic, but patients typically recover after a few hours. However, there are a number of reports of delayed paralysis, and the cause of delayed facial palsy remains uncertain.

This study is the first case report detailing how Korean medicine can be used to treat facial nerve palsy following tooth extraction. This study reports our experience of a patient's favorable recovery.


A 25-year-old male patient experienced acute facial palsy after four premolar teeth were extracted. He was hospitalized in the Pusan National University Korean Medical Hospital. We provided complex Korean traditional medical treatments such as acupuncture, cupping, use of a hot water steamer, and herbal medicine for 18 days.


Using the Yanagihara Grading Score, we found improvements in the patient's voluntary facial movement as his score increased from 22 to 34. Furthermore, his accompanying symptoms, such as dry eye and facial pain, disappeared. However, the patient reported transient pain around acupoints after the acupuncture intervention.


Our study suggests that Korean medical treatments might be effectively used to treat facial nerve palsy after tooth extraction, although further research should be conducted due to the limited number of cases in this area.

Fig. 1

Flowchart of Inclusion Studies

Herbal Medicine Treatment

Change of Yanagihara Grading System


This work was supported by 2-year Research Grant of Pusan National University


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Article information Continued

Fig. 1

Flowchart of Inclusion Studies

Table 1

Herbal Medicine Treatment

Date Herbal Medicine
2013.10.8~10.14 Forsythiae Fructus16 g, Lonicerae Flos 16 g, Uncariae Ramulus et Uncus 12 g, Ulmi Cortex 8 g, Angelicae Dahuricae Radix 8 g, Astragali Radix 8 g, Gleditsiae Semen 6 g, Platycodi Radix 6 g, Atractylodis Rhizoma 6 g, Magnoliae Flos 6 g, Zingiberis Rhizoma 6 g, Saposhnikovia Radix 4 g, Notopterygii Rhizoma 4 g, Ligustici Sinense Radix 4 g, Cimicifugae Rhizoma 4 g, Puerariae Radix 4 g, Schizonepetae Spica 4 g, Glycyrrhizae Radix 4 g, Xanthii Fructus 4 g, Jujubae Fructus 4 g, Amomi Fuctus 4 g, Crataegii Fructus 4 g, Cnidii Rhizoma 3 g, Ephedrae Herba 2 g, Asari Herba Cum Radix 2 g, Menthae Herba 2 g, Gardeniae Fructus 2 g
2013.10.15~10.25 Astragali Radix 12 g, Uncariae Ramulus et Uncus 12 g, Lonicerae Flos 12 g, Forsythiae ructus 12 g, Salviae Miltiorrhizae Radix 12 g, Atractylodis Rhizoma 8 g, Angelicae Gigantis Radix 8 g, Gastrodiae Rhizoma 8 g, Zingiberis Rhizoma 6 g, Rehmanniae Radix Preparat 4 g, Cnidii Rhizoma 4 g, Angelicae Dahuricae Radix 4 g, Paeoniae Radix 4 g, Citri Pericarpium 4 g, Hoelen 4 g, Glycyrrhizae Radix 4 g, Pinelliae Rhizoma 4 g, Notopterygii Rhizoma 4 g, Saposhnikovia Radix 4 g, Gentianae Macrophyllae Radix 4 g, Bombyx Batryticatus 4 g, Amomi Fuctus 4 g, Plantaginis Semen 4 g, Bupleuri Radix 4 g, Cimicifugae Rhizoma 4 g, Cervi Cornu 4 g

Table 2

Change of Yanagihara Grading System

Day 1 (Adm.) Day 6 Day 10 Day 12 Day 14 Day 18 (D/C)
At rest 3 3 3 3 3 3
Wrinkle rorehead 2 3 3 3 3 3
Closure of eye lightly 3 3 4 4 4 4
Closure of eye tightly 3 3 3 3 4 4
Closure of involved eye 3 3 3 3 3 3
Wrinkle nasal root 1 2 3 4 4 4
Blowing cheeks 2 3 3 3 4 4
Whistle 1 2 2 2 3 3
Grin 2 2 2 3 3 3
Depress lower lip 2 2 3 3 3 3

Total 22 26 29 31 34 34