ベル麻痺患者の神経障害転帰に対する異なるレーザー周波数の影響

アクティブコンパレータ：偽レーザー療法

20人の参加者は、顔の8か所に適用される疑似レーザーデバイスを受け取ります。 そして、連続する6週間にわたって合計18回の治療セッション（週3回のセッション）に適用されます。

デバイス：疑似レーザー療法

シャムレーザー装置では、メーカーによりレーザー照射は非活性化されますが、視覚光と音響機能は維持されます。 シャムレーザーの赤外線の出力パワーはゼロmWとなり、顔の8つのポイントに適用されます。

他の：Exercises

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

実験的：低出力レーザー療法

20名の参加者は、低出力レーザー療法（LLLT）を顔の8つのポイントに各5分間、連続6週間にわたり合計18回の治療セッション（週3回のセッション）を受ける

他の：Exercises

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

デバイス：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).

実験的：ガリウムヒ素ダイオードレーザー

20名の参加者は、ガリウムヒ素ダイオード（GaAs）レーザー（BTL-5000レーザー）を、連続6週間にわたり合計18回の治療セッション（週3回のセッション）で受けます。

デバイス：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)

アクティブコンパレータ：高強度レーザー治療

20名の参加者は、パルスネオジムドープヤグレーザーを用いた高強度レーザー治療を、連続6週間にわたり合計18回の治療セッション（週3回のセッション）で受けます。

他の：Exercises

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

デバイス：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