The Serial Ultrasonographic Changes and Clinical Course of Early Peripheral Facial Palsy During Integrative Treatment Including Korean Medicine: A Case Series

This case series aimed to investigate the use of repeated ultrasonographic evaluations to monitor facial nerve changes during the early phase of Bell’s palsy. Three patients with mild-to-moderate facial paralysis were assessed via serial ultrasound imaging, clinical grading, and electromyography (EMG). In all cases, the affected facial nerve appeared swollen early in the disease course, with diameter differences resolving within 2–3 weeks of onset. These structural changes paralleled improvements in the House–Brackmann scale and Sunnybrook Facial Grading System scores, suggesting an association between ultrasound findings and functional recovery. Notably, the patients with a more pronounced initial swelling showed greater axonal damage on EMG, indicating a potential prognostic role for early ultrasound assessments. Despite the small sample size and short observation period, this study supports the use of ultrasonography as a noninvasive tool for monitoring disease progression and treatment response in Bell’s palsy during Korean medicine therapy combined with conventional treatment.