Facial/trigeminal paralysis can be effectively treated with the acupuncture approach, which removes external pathogens like wind and ensures nerve conduction. Early applications may lead to more satisfactory results. In cases where acupuncture is insufficient or in cases where radiofrequency has been applied, the process can be managed with ozone therapy and homeopathy. B-vitamin supplements play a crucial role in increasing the effectiveness of acupuncture and aiding nerve repair. The treatment process can continue by extending the session interval as pain diminishes. For cases unresponsive to conventional treatments, a combination of acupuncture, ozone therapy, and homeopathy can offer a safe and side-effect-free treatment to the patient. Facial paralysis patients can find relief through the combined use of complementary medicine methods.

Peripheral facial paralysis (PFP) is a disease that occurs as a result of compression or cutting of the 7th cranial nerve, causing partial or complete paralysis of the facial muscles. This condition affects the upper and lower facial muscles, which can lead to weakness of the facial muscles, loss of facial expression, loss of taste and corneal sensations, and vision problems (1). Congenital facial paralysis can develop due to various reasons such as infections, trauma, syndromes, tumors, chronic systemic diseases and metabolic disorders. Although the treatment is not definitive, the success rate can be up to 90% with steroid and combined treatments. The spontaneous recovery rate is generally around 80% (2).

A 39-year-old male patient, weighing 60kg and 165cm tall, was admitted to Getat Polyclinic with complaints of lip misalignment, drooling, and pain in the left corner of the mouth with VAS = 9 (pain rating scale). The patient's medical history includes a diagnosis of neurofibromatosis and a history of facial paralysis that he suffered while working as a seasonal worker picking olives. The previously initiated physiotherapy and acupuncture treatments were found to be insufficient, and it was decided to refer the patient to us. The patient had scoliosis, subcutaneous fibrotic nodules and received body and ear acupuncture treatment after taking an informed consent form. Acupuncture sessions were held for 10 sessions, starting once a week. Many points were used on the body, including Yin-tang, Du-20,21, St-8, GB-2 and local points on the paralyzed side. Focus was placed on Jerome, zero, shen-men, kidney and facial nerve points in the ear. Electroacupuncture device and medications such as B vitamin supplements, D-vit, magnesium and calcium were included in the treatment. In the 5th session, a 50% reduction in pain and improvement in control of the lip muscles was observed; In the 10th session, the pain completely disappeared (VAS = 0). It was stated that the patient's masses decreased and his general health condition improved.

As maintenance treatment, MAH ozone therapy was applied, starting from 10 gamma and increasing to 50 gamma in 10 sessions. The patient's blood pressure remained normal. CT and MRI examinations revealed adenoma, retroperitoneal neurofibromas, tumoral lesions and disc findings in the adrenal gland. Laboratory values are within normal limits, and homeopathic remedies hyperC200 and Rhus-tox C30 2*1 were recommended for ongoing treatment.

A 24-year-old female patient, whose pain did not go away despite radiofrequency treatment and botox application at the algology outpatient clinic due to trigeminal neuralgia, applied to Getat Polyclinic. The patient was using Tegretol and his VAS (pain rating scale) was at level 10. In his examinations, glucose 79.6mg/dl, urea 17.5mg/dl, creatinine 0.58mg/dl, uric acid 2.2mg/dl, Mg 1.89mg/dl, st4 0.892ng/dl, B12 733ng/l, folic acid. 3.31ug/l, ferritin 7.82ug/l, Dvit 44.4ng/l, carbamazepine level 10.9ug/ml, wbc 3.81, Hb 12.8g/dl, plt 233. Brain and temporal MRI results were normal. After obtaining an informed consent form and providing the necessary information, the patient was treated for both body and ear acupuncture. A total of 10 sessions were applied; Initially, sessions were held once a week, then every 2-3 weeks. In body acupuncture, Yin-tang, Du-20,21, St-8, GB-2 and local points (ahsi points) on the paralyzed side, ST-36, GB-34, Liv-3, Kid-6,7, SP-6 While ,9, TW-5,6, LI-4,11, P-6, LU-9, H-7 were used, the focus was on Jerome, zero, shen-men, kidney and trigeminal nerve points in the ear. In the first weeks, Hualong intradermal semipermeable needles were used in the ear, and later ASP needles were used. E frequency and Nogier frequency were applied to the paralyzed side with an electroacupuncture device. B vitamin supplements, vitamin D, magnesium and calcium containing medications were prescribed. When the patient did not get relief, the homeopathic remedy hyperC200 and Rhus-tox C30 2*1 were recommended for the continuation of the treatment. He stated that the patient could not receive ozone therapy due to his financial situation and could come to acupuncture every 3 weeks. It was observed that the patient's previous radiofrequency and botox applications may have slowed down the decrease in VAS pain. The patient could not continue due to his economic situation, but there was a 30% pain reduction.

A 43-year-old, 69 kg, 156 cm tall female patient was admitted to Getat Polyclinic with complaints of facial paralysis and electric shock on her face. B12 level was 636 ng/l, Mg level was 1.92 mg/dl, tsh value was 1.91 mu/l and VAS (pain assessment scale) was 7. After the informed consent form was obtained and the necessary information was given, she was taken to both body and ear acupuncture treatment. A total of 10 sessions were applied; Initially, sessions were held once a week, then every 2-3 weeks. In body acupuncture, Yin-tang, Du-20,21, St-8, GB-2, local points (ahsi points) on the paralyzed side, ST-36, GB-34, Liv-3, Kid-6,7, SP-6 While using ,9, TW-5,6, LI-4,11, P-6, LU-9, H-7, Jerome, zero, shen-men, kidney and Facial nerve points in the ear were focused on. In the first weeks, Hualong intradermal semipermeable needles were used in the ear, and later, when the session interval was opened, ASP needles were used. E frequency and Nogier frequency were applied to the paralyzed side with an electroacupuncture device. B vitamin supplements, vitamin D, magnesium and calcium containing medications were prescribed.

A 60% reduction in the patient's pain was noted in the 5th session.

In the maintenance treatment, MAH ozone therapy was administered for 5 sessions, starting from 10 gamma and going up to 50 gamma. Additionally, 20 gamma ozone minor was applied for immune system support. Blood pressure arterial values remained at 120/70 mmHg.

A 52-year-old, 78 kg, 176 cm tall male patient was admitted to Getat Polyclinic due to Ankylosing Spondylitis and facial paralysis. WBC 12.1 u/l, Hb 14.1 g/dl, plt 302, parathormone 63.3 pg/ml, Ca 9.15 pg/ml, SGOT 18 u/l, phosphorus 3.51 mg/dl, creat 0, It was 81 mg/dl, CRP was 12.3 mg/l. VAS (pain assessment scale) was determined as 7. After the informed consent form was obtained and the necessary information was given, the patient was treated with both body and ear acupuncture. A total of 10 sessions were applied; Initially, sessions were held once a week, then every 2-3 weeks. In body acupuncture, Yin-tang, Du-20,21, St-8, GB-2, local points (ahsi points) on the paralyzed side, ST-36, GB-34, Liv-3, Kid-6,7, SP-6 While using ,9, TW-5,6, LI-4,11, P-6, LU-9, H-7, Jerome, zero, shen-men, kidney and Facial nerve points in the ear were focused on. In the first weeks, Hualong intradermal semipermeable needles were used in the ear, and later, when the session interval was opened, ASP needles were used. E frequency and Nogier frequency were applied to the paralyzed side with an electroacupuncture device. B vitamin supplements, vitamin D, magnesium and calcium containing medications were prescribed.

A 60?crease in the patient's pain was noted in the 5th session. At the 10th session, he no longer had pain (VAS = 0). In the maintenance treatment of the patient, MAH ozone therapy was given for 5 sessions, starting from 10 gamma and going up to 50 gamma. Blood pressure arterial values remained at 120/70 mmHg.

Patients with both trigeminal and facial paralysis can apply to getat polyclinics when they do not show improvement despite conventional treatment. Among common pathogens in both cases, cold may appear as a pathogenic factor. While spontaneous and complete recovery occurs in approximately 80-85% of patients within the first three months, mild nerve damage may remain in 15-20% and serious nerve damage may remain in 5%. Total paralysis, advanced age, Ramsey Hunt syndrome (Herpes Zoster Oticus) causing pain, lack of recovery within 3 weeks, presence of additional systemic diseases, conditions causing secondary facial paralysis and more than 50?crease in muscle activation potential, Bell's Palsy are poor prognostic factors. (3, 8, 9) In cases where acetylcholinesterase receptor activity increases in the remaining muscles that persist for more than a year, muscle volume decreases and fibrosis develops within the muscle. This reduces the likelihood of functional muscle reinnervation. Tumor should be considered in cases of facial paralysis lasting more than three weeks and increasing gradually, recurrent unilateral facial paralysis, facial numbness with muscle twitching, facial paralysis lasting more than six months, facial paralysis with other cranial nerve paresis, and malignancy elsewhere in the body. Situations involving symptoms should be evaluated. (4, 5, 7) Intestinal flora, connective tissue, lymphatic system, regulation capacity of the vegetative nervous system (VSS), allergy, pseudo-allergy, food sensitivity, psychological state of the person, hormonal structure, causes of myofascial and trigger point activation, chronic inflammations, trace elements, vitamins. Factors such as mineral and mineral amounts, glucose rates, metabolism and digestive function, acid-base balance of the body, the amount of fluid available or the presence of a disruptive field are affected by medical ozone therapy (10, 12). The most well-known method of medical ozone application is major autohemotherapy. This treatment involves taking some blood (200-250 ml) from the patient intravenously and giving it back to the person after providing the appropriate dose of ozone gas and ozone/oxygen mixture for 5-10 minutes. The initial dose is generally based on 15-20 µg/mL, which is the limit at which the antioxidant effect begins, and is applied within the dose range considered safe in treatment between 10-80 µg/mL. A total of 10-12 sessions are applied, frequently twice a week (14-15). It is known that ozone gas acts by increasing chronic oxidative stress at the cellular level and has anti-inflammatory, immunomodulatory, antihypoxic, wound healing, antimicrobial, metabolic rate and biosynthesis increasing properties (16-17). Medical ozone therapy is accepted as an increasingly widespread treatment method due to its safety, easy applicability, low cost and other advantages (12, 13). Homeopathic treatment is a complementary treatment method in which significant reductions in disease severity are observed after the 24th month. It has been stated that homeopathic treatment containing Hypericum provides effective results for conditions such as mitochondrial dysfunction. This plant may also be effective against organ tumors that develop due to disruptions in mitochondrial functions. Most studies in the literature have focused on H. perforatum L. (common St. John's wort), one of the best herbal medicines in the world with its complex spectrum of bioactive compounds ( 19 ).

In cases of facial paralysis that do not respond to conventional treatment, traditional complementary medicine methods can be applied. Among these treatments, acupuncture, ozone therapy and homeopathy are options that can yield results. Acupuncture can play a role in nerve repair through nerve communication, ozone therapy can play a role in nerve repair with its anti-inflammatory effect, and homeopathy can play a role in nerve repair thanks to herbal extracts. The earlier the treatment is started, the faster the results can be achieved.