Abstract
Diminished facial movement and marked facial asymmetry can lead to a consistent psychological burden. Bell′s palsy (BP) is one of the most common causes of facial nerve illness, which comes with unilateral acute facial paresis. Nowadays, no clear guidelines for treating BP are available. We carried out a case series study to test the efficacy of photobiomodulation (PBM) therapy in patients with BP non-responsive to standard treatment. The study was experimentally performed at the Department of Surgical and Diagnostic Sciences, University of Genoa (Genoa, Italy), in accordance with case report guidelines. Patients were referred to our department by colleagues for evaluation to be included in the case series because no consistent improvement was observed at least 3 months from the diagnosis of BP. All the patients interrupted their pharmacological therapy before the initiation of PBM therapy. PBM therapy (808 nm, 1 W irradiated in continuous-wave for 60 s on spot-size 1 cm2; 1 W/cm2; 60 J/cm2; and 60 J) was administered every 2 days until complete resolution. Evaluation of the House-Brackmann scale was performed before and after treatments. Fourteen patients were screened as eligible for the study. Patients were Caucasians (36% females and 64% males) with a mean age ± standard deviation of 56.07 ± 15.21 years. Eleven patients out of 14, who experienced BP a maximum of 6 months, completely recovered through PBM. The three patients that did not show improvement were those who had experienced BP for years. PBM could be a supportive therapy for the management of BP in patients non-responsive to standard treatment. However, randomized controlled trials are necessary to sustain our encouraging results, exclude bias, and better explain the boundary between the time from diagnosis and the recovery of BP through PBM therapy.
Highlights
Facial expression plays a pivotal role in social relationships and self-esteem [1]
Persistence of diminished facial movement and marked facial asymmetry can lead to a consistent psychological burden, social alienation, and depression for patients, which may result in decreased productivity and higher health care expenses [2,3]
The diagnosis is mainly based on exclusion criterion and functional assessments through scales of severity, while the instrumental investigation is considered only because of possible iatrogenic, tumoral, or traumatic origin [7]. Many conditions, such as GuillainBarré syndrome, Ramsay Hunt syndrome, reactions to intranasal influenza vaccines, Lyme disease, sarcoidosis, cholesteatoma, tumors, and general structural lesions in the parotid gland and ear can mimic the symptoms of Bell0 s palsy (BP) [4,5,8]
Summary
Facial expression plays a pivotal role in social relationships and self-esteem [1]. Persistence of diminished facial movement and marked facial asymmetry can lead to a consistent psychological burden, social alienation, and depression for patients, which may result in decreased productivity and higher health care expenses [2,3].Bell0 s palsy (BP) is one of the most common causes of facial nerve illness. The diagnosis is mainly based on exclusion criterion and functional assessments through scales of severity, while the instrumental investigation is considered only because of possible iatrogenic, tumoral, or traumatic origin [7] Many conditions, such as GuillainBarré syndrome, Ramsay Hunt syndrome, reactions to intranasal influenza vaccines, Lyme disease, sarcoidosis, cholesteatoma, tumors, and general structural lesions in the parotid gland and ear can mimic the symptoms of BP [4,5,8]. These disorders can represent isolated facial nerve palsies, they usually cause additional problems that distinguish them from it [4,5,8]. BP is accompanied by unilateral acute facial paresis that evolves in 24–48 h [4] and reaches maximum facial weakness in 3–7 days [4,5,8]
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