Download PDF
Facial Plast Surg 2024; 40(04): 441-449
DOI: 10.1055/a-2295-7720
Original Article

Needles, Herbs, and Electricity: A Meta-Analysis of Traditional Eastern Medicine in the Management of Facial Paralysis

Ariel Harsinay 
1   Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
,
Anusha Patil
2   School of Medicine and Dentistry, University of Rochester, Rochester, New York
,
Safi Ali-Khan
3   Department of Plastic Surgery, University of Rochester Medical Center, Rochester, New York
,
Keith Sweitzer
3   Department of Plastic Surgery, University of Rochester Medical Center, Rochester, New York
,
Jonathan I. Leckenby
3   Department of Plastic Surgery, University of Rochester Medical Center, Rochester, New York
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

In Eastern nations, interventions like acupuncture and herbal medicine are often first-line for patients presenting with facial paralysis. Despite the rising popularity of Eastern medicine in Western nations, the literature assessing whether Eastern medicine interventions should be recommended for patients with facial paralysis is lacking. This meta-analysis aims to define what Eastern medicine interventions exist for the management of facial paralysis and assess whether current research supports these approaches as safe and effective. The PubMed and Cochrane databases were reviewed in accordance with PRISMA guidelines. Inclusion criteria consisted of peer-reviewed studies published between 2000 and 2023 that reported on Eastern medicine, also described as, “complementary” or “alternative” interventions for facial paralysis. Effective and cured rates were the primary outcomes extracted from the literature. Interventions within these studies were categorized into six groups: (1) standard acupuncture, (2) special needle therapies, (3) needle therapy + other alternative treatments, (4) herbal medicine, (5) alternative treatments + Western medicine, and (6) Western medicine alone. A multiple-treatment meta-analysis was performed to assess differences in effective and cured rates. Fifteen studies involving Eastern medicine for the treatment of facial paralysis met the inclusion criteria. No significant differences were found in effective and cured rates across groups. Multiple quality concerns were noted, such as the lack of control groups, blinding, and randomization noted in several studies. Many studies failed to report complications, preventing conclusions from being drawn on the safety of these Eastern medicine interventions. This meta-analysis was unable to support the recommendation of Eastern medicine approaches for patients with facial paralysis. No Eastern medicine treatments, combination of Eastern medicine treatments, or Eastern medicine treatments given with Western medicine were seen to be more effective than Western medicine alone.

Keywords

facial paralysis - Bell's palsy - alternative medicine - Eastern medicine - integrative medicine


Publication History

Accepted Manuscript online:
27 March 2024

Article published online:
30 April 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Duffy JD, Cohen L, Chaoul A. Integrative medicine in mental health. In: Friedman HS. ed. Encyclopedia of Mental Health. 2nd ed.. Oxford: Academic Press; 2016: 384-389
    Google Scholar
  • 2 Zeng YS, Hume AL. 78—What is the evidence for integrative and alternative therapies in palliative care?. In: Goldstein NE, Woodrell CD, Morrison RS. eds., Evidence-Based Practice of Palliative Medicine. 2nd ed.. New Delhi: Elsevier; 2023: 678-683
    Google Scholar
  • 3 Chiaramonte D, Adamo CD, Morrison B. 49—Integrative approaches to pain management. In: Benzon HT. et al. eds. Practical Management of Pain. 5th ed.. Philadelphia: Mosby; 2014: 658-668.e3
    Google Scholar
  • 4 Tabish SA. Complementary and alternative healthcare: is it evidence-based?. Int J Health Sci (Qassim) 2008; 2 (01) V-IX
    PubMedGoogle Scholar
  • 5 Americans' health care behaviors and use of conventional and alternative medicine. Washington, D.C.: Pew Research Center; 2017
    Google Scholar
  • 6 Lee SM, Lee S, Park JH, Park JJ, Lee S. A close look at an integrative treatment package for Bell's palsy in Korea. Complement Ther Clin Pract 2017; 26: 76-83
    CrossrefPubMedGoogle Scholar
  • 7 Navarro Vila C. Reconstruction in Facial Paralysis. Switzerland: Springer International Publishing AG; 2015: 203-219
    Google Scholar
  • 8 Ljøstad U, Økstad S, Topstad T, Mygland A, Monstad P. Acute peripheral facial palsy in adults. J Neurol 2005; 252 (06) 672-676
    CrossrefPubMedGoogle Scholar
  • 9 Bleicher JN, Hamiel S, Gengler JS, Antimarino J. A survey of facial paralysis: etiology and incidence. Ear Nose Throat J 1996; 75 (06) 355-358
    CrossrefPubMedGoogle Scholar
  • 10 Dalrymple SN, Row JH, Gazewood J. Bell palsy: rapid evidence review. Am Fam Physician 2023; 107 (04) 415-420
    PubMedGoogle Scholar
  • 11 Chen N, Zhou M, He L, Zhou D, Li N. Acupuncture for Bell's palsy. Cochrane Database Syst Rev 2010; 2010 (08) CD002914
    PubMedGoogle Scholar
  • 12 Chen WQ, Li Q. Electroacupuncture combined with Qianzhengsan decoction for the treatment of peripheral facial paralysis: a retrospective study. Medicine (Baltimore) 2022; 101 (37) e30740
    CrossrefPubMedGoogle Scholar
  • 13 Zhong W, Yu H, Rao X. et al. Efficacy of manipulative acupuncture therapy monitored by LSCI technology in patients with severe Bell's palsy: a randomized controlled trial. Evid Based Complement Alternat Med 2020; 2020: 6531743
    CrossrefPubMedGoogle Scholar
  • 14 Liang L, Qiang F. Observation on the clinical effect of acupuncture and moxibustion combined with repeated transcranial magnetic stimulation on facial paralysis. Comput Math Methods Med 2021; 2021: 9642677
    CrossrefPubMedGoogle Scholar
  • 15 Wang XJ, He NN, Ji WB, Yu L, Zhang P. Effect of penetration electroacupuncture combined with intermediate frequency electrotherapy, facial acupoint massage, and cervical reduction on facial nerve function and curative effect of senile refractory facial paralysis. J Healthc Eng 2021; 2021: 3776006
    PubMedGoogle Scholar
  • 16 Wang LL, Guan L, Hao PL, Du JL, Zhang MX. Acupuncture and vitamin B12 injection for Bell's palsy: no high-quality evidence exists. Neural Regen Res 2015; 10 (05) 808-813
    CrossrefPubMedGoogle Scholar
  • 17 Lee JA, Kim JU, Choi J. Clinical practice guidelines of Korean medicine for facial palsy: an evidence-based approach. Eur J Integr Med 2016; 8 (03) 176-181
    CrossrefPubMedGoogle Scholar
  • 18 Zhang R, Wu T, Wang R, Wang D, Liu Q. Compare the efficacy of acupuncture with drugs in the treatment of Bell's palsy: a systematic review and meta-analysis of RCTs. Medicine (Baltimore) 2019; 98 (19) e15566
    CrossrefPubMedGoogle Scholar
  • 19 Li Y, Wu X, Hu KM, Chen XQ. Current situation and evaluation of clinical studies on acupuncture and moxibustion treatment of peripheral facial paralysis at selected stages. J Tradit Chin Med 2010; 30 (02) 153-159
    CrossrefPubMedGoogle Scholar
  • 20 Wang QP, Bai M, Lei D. Effectiveness of acupuncture in treatment of facial spasm: a meta-analysis. Altern Ther Health Med 2012; 18 (03) 45-52
    PubMedGoogle Scholar
  • 21 Vivera MJ, Gomersall JS. The effectiveness of ayurvedic oil-based nasal instillation (Nasya) medicines in the treatment of facial paralysis (Ardita): a systematic review. JBI Database Syst Rev Implement Reports 2016; 14 (04) 198-228
    CrossrefPubMedGoogle Scholar
  • 22 Li Y, Liang FR, Yu SG. et al. Efficacy of acupuncture and moxibustion in treating Bell's palsy: a multicenter randomized controlled trial in China. Chin Med J (Engl) 2004; 117 (10) 1502-1506
    PubMedGoogle Scholar
  • 23 Wang WH, Jiang RW, Liu NC. Electroacupuncture is effective for peripheral facial paralysis: a meta-analysis. Evid Based Complement Alternat Med 2020; 2020: 5419407
    PubMedGoogle Scholar
  • 24 Zheng H, Li Y, Chen M. Evidence based acupuncture practice recommendations for peripheral facial paralysis. Am J Chin Med 2009; 37 (01) 35-43
    CrossrefPubMedGoogle Scholar
  • 25 Jeong HI, Kim KH, Oh YT. et al. Korean medicine for treating facial palsy: a literature review of case reports. J Pharmacopuncture 2018; 21 (04) 214-215
    CrossrefPubMedGoogle Scholar
  • 26 Yu Z, Shen M, Shang W, Wu J, Xuan L. Timing of acupuncture treatment in peripheral facial paralysis: a systematic review and meta-analysis. Comput Math Methods Med 2021; 2021: 4221955
    PubMedGoogle Scholar
  • 27 Li P, Qiu T, Qin C. Efficacy of acupuncture for Bell's palsy: a systematic review and meta-analysis of randomized controlled trials. PLoS One 2015; 10 (05) e0121880
    CrossrefPubMedGoogle Scholar
  • 28 Kim TH, Lee MS, Birch S, Alraek T. Plausible mechanism of sham acupuncture based on biomarkers: a systematic review of randomized controlled trials. Front Neurosci 2022; 16: 834112
    CrossrefPubMedGoogle Scholar
  • 29 Peitersen E. Bell's palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol Suppl 2002; (549) 4-30
    CrossrefPubMedGoogle Scholar
  • 30 Zhang D. A method of selecting acupoints for acupuncture treatment of peripheral facial paralysis by thermography. Am J Chin Med 2007; 35 (06) 967-975
    CrossrefPubMedGoogle Scholar
  • 31 Tong FM, Chow SK, Chan PY. et al. A prospective randomised controlled study on efficacies of acupuncture and steroid in treatment of idiopathic peripheral facial paralysis. Acupunct Med 2009; 27 (04) 169-173
    CrossrefPubMedGoogle Scholar
  • 32 Yin L, Weiqing C, Wei K, Shaohua W. Chinese medicinal herb therapy for the rehabilitation of peripheral facial palsy. J Med Plants Res 2010; 4: 455-458
    PubMedGoogle Scholar
  • 33 Ahn CB, Lee SJ, Lee JC, Fossion JP, Sant'Ana A. A clinical pilot study comparing traditional acupuncture to combined acupuncture for treating headache, trigeminal neuralgia and retro-auricular pain in facial palsy. J Acupunct Meridian Stud 2011; 4 (01) 29-43
    CrossrefPubMedGoogle Scholar
  • 34 Jin DE, Jang SY, Jung YS, Choi GH, Shin HC. Herbal medicine for treating Bell's palsy: a retrospective chart review. Integr Med Res 2020; 9 (04) 100418
    CrossrefPubMedGoogle Scholar
  • 35 Gökçe Kütük S, Özkan Y, Topuz MF, Kütük M. The efficacy of electro-acupuncture added to standard therapy in the management of Bell palsy. J Craniofac Surg 2020; 31 (07) 1967-1970
    CrossrefPubMedGoogle Scholar
  • 36 Yu BY, Wang YP, Shang HC. et al. Effect of thick-needle therapy in patients with Bell's palsy at recovery stage: a multi-center randomized controlled trial. Chin J Integr Med 2020; 26 (06) 455-461
    CrossrefPubMedGoogle Scholar
  • 37 Zhu P, Wang H, Zhang L, Jiang X. Deep learning-based surface nerve electromyography data of e-health electroacupuncture in treatment of peripheral facial paralysis. Comput Math Methods Med 2022; 2022: 8436741
    PubMedGoogle Scholar
  • 38 Zhang T-t, Wang N-h, He T-y. Subcutaneous needling and peripheral facial palsy: A report of 30 cases. J Acupunct Tuina Sci 2007; 5 (02) 118-120
    CrossrefPubMedGoogle Scholar
  • 39 Brenner MJ, Neely JG. Approaches to grading facial nerve function. Semin Plast Surg 2004; 18 (01) 13-22
    Article in Thieme ConnectPubMedGoogle Scholar
  • 40 Ma Y, Dong M, Zhou K, Mita C, Liu J, Wayne PM. Publication trends in acupuncture research: a 20-year bibliometric analysis based on PubMed. PLoS One 2016; 11 (12) e0168123
    CrossrefPubMedGoogle Scholar