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Our study was designed and written before the publication of some recent randomised controlled trials on treatment of facial palsy, including those mentioned by Dr Amer and also some others using acupuncture; our design and results will have been different if those results were known.
The number of patients in the steroid group was larger, due to randomisation, which was unexpected and uncontrollable. We tried to focus our study on comparison of steroid and acupuncture. The initial grade of facial palsy did affect the outcome, as mentioned in our Discussion column, but stratification would split them into even smaller groups and would further decrease the statistical significance. The effects of diabetes and hypertension were not the focus of our study.
We tried to recruit more patients into the study by including those with onset within 2 weeks. Most patients were treated early with an average onset of just 2.6 days.
There were various reported acupuncture regime in treating facial palsy, including electroacupuncture, acupuncture plus moxibustion, acupuncture using different acupoints, strength and duration, and we based our protocol on standard official acupuncture textbooks for senior colleges in mainland China. Electroacupuncture is not recommended for acute facial paralysis, according to the textbooks.
Our study was certainly not perfect, as we mentioned in the Discussion. We hope we can prompt a large-scale study on the comparison of efficacies of steroid and acupuncture with sufficient statistical significance in future.
Provenance and peer review Not commissioned; not externally peer reviewed.
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