Abstract
Chronic sinusitis is one of the most common chronic diseases. In this research, intra- oral radiation of low-level laser has been compared with extra-oral low level laser radiation in treating maxillary chronic sinusitis for the first time. In this clinical trial, 40 patients were enrolled. Treatment plan was performed in 8 sessions, every other day, and using low-level diode laser with 810 nm. SNOT-22 questionnaire and rhinomanometry were used for evaluating patients. Mann whiteny, Fridman and wilcoxson tests were used for data analyses. P. value < 0.05 was considered statistically significant. All studied variables were improved using intra and extra oral low-level laser and this improvement was statistically significant (P. value<0.05). Comparing the two groups, Intra-oral laser therapy significantly (P. value<0.05) improved rhinomanometry variables compared to extra-oral laser therapy. The two groups showed no significant difference in improvement of clinical symptoms that contained in the SNOT-22 questionnaire except for sneeze which intra-oral laser therapy significantly decreased this variable (P. value<0.05). It should be noted that intra-oral radiation reduced all symptoms earlier than extra-oral radiation. After Six-months, in intra-oral group there was no significant difference between the results of completion and the results of 8th treatment session (P. value> 0.05). But in extra-oral group only post nasal discharge and thick nasal discharge were significantly increased compared with the results of the 8th session of radiation. Other symptoms showed no significant difference (P. value>0.05). Using intra and extra oral low-level laser therapy is a suitable way to treat patients with chronic maxillary sinusitis.
Highlights
Sinusitis is one of the most common diagnoses in primary care. [1] It is one of the most common chronic diseases, affecting 14–16% of the adult US population and highly prevalent and has a considerable impact on quality of life and health care expenditures. [2, 3] Because the nature and etiology of chronic sinusitis are not completely unknown, there is not any standard treatment for this disease [4] Kinds of treatment of CRS is aimed at reducing underlying inflammation and facilitating clearance of the paranasal sinuses
[6] Therapeutic ultrasound and laser therapy are blocking molecular communication between bacteria, inhibiting biofilm production and disrupting bacterial biofilms [6,7,8] low level laser therapy LLLT is a form of phototherapy that delivers low-power (≤500 mw) coherent and collimated beam of light of a single wavelength [6]
LLLT is attributed to non-thermal events. It involves the absorption of photon radiation by chromophores such as cytochrome C oxidase within the mitochondria leading to release of nitric oxide (NO), and an increase in ATP levels
Summary
Sinusitis is one of the most common diagnoses in primary care. [1] It is one of the most common chronic diseases, affecting 14–16% of the adult US population and highly prevalent and has a considerable impact on quality of life and health care expenditures. [2, 3] Because the nature and etiology of chronic sinusitis are not completely unknown, there is not any standard treatment for this disease [4] Kinds of treatment of CRS is aimed at reducing underlying inflammation and facilitating clearance of the paranasal sinuses. Hamed Mortazavi et al.: Comparison of Therapeutic Effects of Intra and Extra Oral Low Level Laser Radiation in Maxillary Chronic Sinusitis term treatment and long-term use of systemic drugs certainly has many side effects. In the patients without anatomical obstruction, functional endoscopic surgeries are not superior to drug therapies Because of these difficulties in treating chronic sinusitis, researchers and clinicians suggested new modalities such as ultrasound therapy and laser therapy [6] Therapeutic ultrasound and laser therapy are blocking molecular communication between bacteria, inhibiting biofilm production and disrupting bacterial biofilms [6,7,8] low level laser therapy LLLT is a form of phototherapy that delivers low-power (≤500 mw) coherent and collimated beam of light of a single wavelength [6]. This study is the first long-term clinical study to compare therapeutic effects of intra and extra oral low-level laser radiation in maxillary chronic sinusitis
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