Ultrasound-Guided Canggui Tanxue Acupuncture for Post-Paralytic Facial Synkinesis: A Randomized Controlled Trial

ObjectiveThis randomized controlled trial aimed to evaluate the efficacy and safety of ultrasound-guided Canggui Tanxue acupuncture in treating post-paralytic facial synkinesis. MethodsSixty-four patients were randomly allocated to either an Ultrasound-guided Group (n=31) receiving real-time shear wave elastography (SWE)-navigated Canggui Tanxue acupuncture targeting hypertonic muscles (Levator Labii Superioris, Depressor Anguli Oris, Depressor Labii Inferioris) with Youngs modulus >10 kPa, or a Control Group (n=33) receiving conventional meridian-based acupuncture with facial "three-line" method. Both groups received six treatment sessions over three weeks. Primary outcome was SWE-quantified reduction in Youngs modulus of target muscles. Secondary outcomes included House-Brackmann (H-B) grading, Facial Disability Index (FDI), and clinical efficacy rate based on H-B improvement. ResultsThe Ultrasound-guided Group demonstrated significantly greater reductions in Youngs modulus versus controls (Depressor Anguli Oris: {Delta}3.00 kPa vs. 1.10 kPa, P=0.001; Levator Labii Superioris: {Delta}5.60 kPa vs. 1.00 kPa, P<0.001). Clinically, the intervention group achieved superior facial functional recovery with an 87.1% total efficacy rate compared to 42.4% in controls (P<0.001), alongside significantly better improvement in FDI physical function scores (74.84{+/-}8.42 vs. 68.94{+/-}13.68, P=0.04). However, no significant intergroup difference was observed in FDI social function scores (FDIS: P=0.92), suggesting psychosocial recovery may lag behind functional improvements. Only two minor subcutaneous hematomas (6.5%) were observed with no neurovascular complications. ConclusionUltrasound-guided Canggui Tanxue acupuncture significantly reduces pathological muscle tension and improves functional outcomes in post-paralytic synkinesis, demonstrating its potential as a safe and precise treatment modality.