Photobiomodulation with low-level laser as an adjuvant in the functional rehabilitation of peripheral facial paralysis

Peripheral facial palsy represents a neurological condition with motor repercussions. Although physiotherapy is the mainstay of treatment, the evidence on the clinical efficacy of low-level laser therapy (LLLT) using photobiomodulation is still limited and heterogeneous. The primary objective is to assess the impact of low-level therapeutic laser (Class 3B) on the functional recovery of patients with peripheral facial paralysis treated at the Daniel Alcides Carrión Hospital in Huancayo, Peru. A pre-post quasi-experimental study was conducted in 41 patients with peripheral facial paralysis, of which 80.5% had Bell’s palsy. The treatment consisted of photobiomodulation with low-intensity laser (1064 nm, 63 mW, 3 J/cm2, 40 s/point) applied in ten sessions. Facial function was assessed using the House-Brackmann scale before and after treatment. The data were analyzed with the Wilcoxon test (p<0.05). The median House-Brackmann score was reduced from 4 to 2, representing a significant improvement (Δ=−2; p<0.001; r=0.87). LLLT-based photobiomodulation has proven to be safe and effective in the improvement of facial function in peripheral facial palsy, with no adverse effects. Patients with symptom duration of less than 4 weeks had significantly better functional recovery. The therapeutic effect of LLLT is supported by these results. Therefore, strict randomized controlled trials (RCTs) should be required to verify these results and provide unanimous dosimetry and frequency protocols to achieve the best clinical implementation.