Role of low-level laser therapy added to facial expression exercises in patients with idiopathic facial (Bell’s) palsy

Abstract

The aim of the present study was to investigate the efficacy of low-level laser therapy in conjunction with conventional facial exercise treatment on functional outcomes during the early recovery period in patients with facial paralysis. Forty-six patients (mean age 41 ± 9.7 years; 40 women and 6 men) were randomized into two groups. Patients in the first group received low-level laser treatment as well as facial exercise treatment, while patients in the second group participated in facial exercise intervention alone. Laser treatment was administered at a wavelength of 830 nm, output power of 100 Mw, and frequency of 1 KHz using a gallium-aluminum-arsenide (GaAIAs, infrared laser) diode laser. A mean energy density of 10 J/cm was administered to eight points of the affected side of the face three times per week, for a total of 6 weeks. The rate of facial improvement was evaluated using the facial disability index (FDI) before, 3 weeks after, and 6 weeks after treatment. Friedman analysis of variance was performed to compare the data from the parameters repeatedly measured in the inner-group analysis. Bonferroni correction was performed to compare between groups as a post hoc test if the variance analysis test result was significant. To detect the group differences, the Bonferroni Student t test was used. The Mann-Whitney U test was used to compare numeric data between the groups. In the exercise group, although no significant difference in FDI scores was noted between the start of treatment and week 3 (p < 0.05), significant improvement was observed at week 6 (p < 0.001). In the laser group, significant improvement in FDI scores relative to baseline was observed at 3 and 6 weeks (p < 0.001). Improvements in FDI scores were significantly greater at weeks 3 and 6 in the laser group than those in the exercise group (p < 0.05). Our findings indicate that combined treatment with low-level laser therapy (LLLT) and exercise therapy is associated with significant improvements in FDI when compared with exercise therapy alone.

Bell's palsy treated with photobiomodulation in an adolescent: Rare case report and review of the published literature

“…4,6 Interestingly, PBM associated to facial exercises is also more effective than facial massage and exercises alone in adult patients with BP. 2,5 In the current report, the patient showed complete recovery after PBM alone.…”

“…Regarding treatment modalities, PBM shows analogous overall BP recovery if compared to corticosteroid therapy, even the combination of PBM and corticosteroid is not superior to PBM alone . Interestingly, PBM associated to facial exercises is also more effective than facial massage and exercises alone in adult patients with BP . In the current report, the patient showed complete recovery after PBM alone.…”

“…Photobiomodulation has been shown as an effective alternative therapy for BP treatment, especially for children and those who cannot take drugs, such as diabetic and hypertensive patients. There is no consensus on the use of corticosteroids for the treatment of BP in the pediatric population; consonantly, laser therapy presents no side effects, significantly faster clinical improvement, also being a true noninvasive approach, which facilitates its use in pediatric patients.…”

“…Few studies have been published about the use of PBM for the treatment of facial paralysis and only one of them describes its use in a child (Table ). Infrared laser was the most commonly used, which makes sense due to aiming for deeper light penetration for deeper tissues (nerve fibers), including the present case.…”

“…Photobiomodulation diminishes the recovery time of BP, avoiding the occurrence of any complication, as eye injuries, hyperkinesis, synkinesis and/or contracture . Long‐term facial paralysis involves psychological aspects; and facial disfiguration can lead to emotional stress, especially in children and adolescents.…”