Diferentes Frecuencias Láser en los Resultados Neuropáticos de Pacientes con Parálisis de Bell

Comparador activo: terapia láser simulada

20 participantes recibirán un dispositivo láser simulado, que se aplicará en los ocho puntos de la cara. Y se aplicará durante un total de 18 sesiones de tratamiento durante un período de 6 semanas consecutivas (tres sesiones/semana).

Dispositivo: terapia láser simulada

la irradiación láser será desactivada en el dispositivo láser simulado por su fabricante, pero se mantendrán sus funciones de luz visual y acústica. La potencia de salida de la luz infrarroja del láser simulado será de cero mW, y se aplicará sobre los ocho puntos de la cara

Otro: Exercises

Patients in all treatment groups received the same standardized rehabilitation programme consisting of facial massage, mirror exercises, and resisted facial and neck exercise

Experimental: Terapia con Láser de Baja Potencia

20 participantes recibirán Terapia Láser de Baja Intensidad (LLLT) durante 5 minutos en ocho puntos de la cara, con un total de 18 sesiones de tratamiento durante un período de 6 semanas consecutivas (tres sesiones/semana)

Otro: Exercises

Patients in all treatment groups received the same standardized rehabilitation programme consisting of facial massage, mirror exercises, and resisted facial and neck exercise

Dispositivo: Low-Level Laser Therapy

Low-Level Laser Therapy (LLLT) for 5 min over eight points over the face, with the laser probe in direct contact with the superficial roots of the facial nerve. The parameters will be used wavelength of 808 nm (Polaris HP, Astar, Bielsko-Biała, Poland) and 980 nm (TheraLASER max, TheraMarkt, Germany), frequency of 1 kilohertz, the duty cycle of 80%, and energy density of 10 J/cm'. During each session, the total energy will be delivered to the patient are 1440 J per session (8 treatment points × 180 J per point; 3 W average power over a 6 cm² applicator, 60 s per point).

Experimental: láser de diodo de arseniuro de galio

20 participantes recibirán láser de diodo de arseniuro de galio (GaAs) (láser BTL-5000) para un total de 18 sesiones de tratamiento durante un período de 6 semanas consecutivas (tres sesiones/semana)

Dispositivo: gallium arsenide diode laser (BTL-5000 laser)

gallium arsenide diode laser (BTL-5000 laser) will be used with infrared probes of 830 nm wavelength and 100 mW output power, average energy density of 10 J/em?, a frequency of 1 kilohertz, and a duty cycle of 80 %. In all cases, the laser will be in direct contact with the superficial roots of the facial nerve on the affected side and will be applied for 2 min and 5 s per point for 8 points with a total energy of 1440 J per session (8 treatment points × 180 J per point; 3 W average power over a 6 cm² applicator, 60 s per point)

Comparador activo: tratamiento con láser de alta intensidad

20 participantes recibirán tratamiento con láser de alta intensidad con un láser de granate de itrio y aluminio dopado con neodimio pulsado durante un total de 18 sesiones de tratamiento durante un período de 6 semanas consecutivas (tres sesiones/semana)

Otro: Exercises

Patients in all treatment groups received the same standardized rehabilitation programme consisting of facial massage, mirror exercises, and resisted facial and neck exercise

Dispositivo: high intensity laser treatment

High intensity laser therapy treatment with pulsed neodymium doped: yttrium aluminum garnet laser. The apparatus provided the following options: pulsed emission (1,064 nm), very high peak powers (3 kW), high levels of fluency (energy density) (810-1,780 mJ/cm), brief duration (120-150 Ms), low frequency (10-40 Hertz), and a duty cycle of approximately 0.1 %. High intensity laser therapy will be applied with contact and perpendicular to the superficial roots of the facial nerve of the affected side. The time of application will be 7 s/per point with an energy density of 10 J/em'. The total energy delivered to the patient during one session will be 1440 J per session (8 treatment points × 180 J per point; 3 W average power over a 6 cm² applicator, 60 s per point). The device calculates the number of pulses, energy received for each session, and the total energy delivered to the patient during the treatment session

assessment of Compound motor action potential of facial nerve

Compound motor action potential of the facial nerve was evaluated using electroneurography. This involved measuring latency and amplitude differences between the affected and non-affected sides of the nasalis muscle. Latency was calculated from the baseline to the initial deflection, while amplitude was determined as peak-to-peak measurements, with both measures yielding Facial-nerve distal latency and CMAP amplitude at the nasalis.

secondary Outcome

Facial Disability Index - Physical subscale; Facial Disability Index - Social subscale