Laser and vacuum therapy for treatment of facial nerve palsies

Facial nerve (FN) palsies consist of paralysis of unknown origin potentially caused by metabolic disorders, trauma, and infectious diseases. Currently, FN injuries diagnosed as Bell's Palsy (BP) are characterized by total involvement of the affected hemiface, leading to multiple consequences including lack of eye lubrication. Our study employed low-level laser therapy (LLLT) for recovery of FN palsies by patient 1 with BP and patient 2 with trauma. Our LLLT protocol used gallium aluminum arsenide (GaAlAs) laser (wavelength 780 nm and power 70mW) during 60 seconds per 0.04 cm² of illuminated area for BP treatment (patient 1), and lasers emitting at 660 and 808 nm (power 600 mW) during 3 minutes per 2-3 cm² of illuminated area used synergistically with vacuum therapy equipment for trauma-based FN-palsy treatment (patient 2). Patient 1 received 2 sessions per week over 2 months and patient 2 over 3 months. LTTT treatments resulted in complete recovery of patients 1 and 2. No medication was administered during vacuum therapy and laser treatment. Normal facial expression was achieved including facial symmetry at rest and enhanced facial movement. Our results indicated that LLLT can enable nerve regeneration, as facial muscles recovered their normal functions. Based on these results, we believe laser therapy may be a viable approach to nerve regeneration and may have clinical relevance to be confirmed upon increasing patient numbers in future studies. Also, the combination between LLLT and vacuum therapy may arise as an alternative treatment to accelerate the recovery of the facial expression of FN-palsies and BP patients.