“At-Home” Photobiomodulation: A New Approach for Bell’s Palsy Treatment

Abstract

Objective. This report is the first one to describe the possibility to use “self‐administered” photobiomodulation (PBM) for Bell’s palsy (BP) treatment. Background. BP is a peripheral disorder of the facial nerve causing sudden paralysis of unilateral facial muscles, and PBM has been successfully suggested for its treatment without any side effect. This is the first case report where a laser device was successfully used at home by the patient herself to treat BP opening new perspectives on the therapy of this disease. Methods. This report describes the “at-home PBM” treatment performed on a 15-year-old girl who presented BP consisting of acute pain on the right side of her face, difficulty in biting and dripping saliva from the right side of her lips. The treatment was performed twice a day by cutaneous applications, each of 15 minutes (total fluence 48 J/cm2) in an area corresponding to the parotid gland by a device emitting at 808 nm at 250 mW output power. Results. Two weeks after PBM treatment, performed at home twice a day by the patient herself without any kind of pharmacological therapy, the complete disappearing of the disease was noticed with no side effects. Conclusion. With the limitations due to a single case report and with the need of further clinical trials to confirm it, “at-home PBM” seems to represent a good and safe approach to the treatment of BP.

Management of Bell’s Palsy with Phototherapy

“…We have identified fourteen relevant papers covering the use of phototherapy in the management of Bell's Palsy, including four RCTs [28,[32][33][34], one prospective study [35], one case series [36], and eight case reports [29,[37][38][39][40][41][42][43], which we review.…”

“…Our review shows that the most studied PBM is LLLT [28,32,33,35,37,39,40,42,43]. Others include high-intensity laser therapy (HILT) [29,32,36,41], monochromatic infrared energy (MIRE) [38] and laser acupuncture [34].…”

“…Most subjects were adults, except for a case report on a pediatric patient [37] and two case reports on adolescents [40,42]. We categorized the papers into acute, subacute, chronic, and unspecified, according to the time patients received PBM treatments.…”

“…A review of the search results showed that acute and subacute Bell's palsy respond favorably to PBM [32,33,[37][38][39][40][41][42]. Chronic Bell's palsy, however, responds less satisfactory [34,36,38].…”

“…The therapy improves the recovery of injured nerves, slows motor neuron degeneration, and promotes axonal growth and myelination. The treatment can also lower the pro-inflammatory cytokine level and raise the anti-inflammatory cytokine level [32,35,40]. In addition, evidence shows that the HSV-1 can be effectively suppressed by PBM [50].…”