Efficacy of photobiomodulation therapy in managing iatrogenic trigeminal nerve injury: A retrospective case series

TL;DR

This study examined whether photobiomodulation therapy helps manage long-term nerve damage from trigeminal neuropathy but found no strong evidence of effectiveness.

Contribution

The study provides insights into the limitations of a specific PBM protocol for trigeminal nerve injuries and highlights the need for standardized trials.

Findings

59% of patients reported subjective improvement, but results were not statistically significant.

No significant associations were found between treatment outcomes and factors like gender or time to treatment.

The study suggests that laser parameters and placebo effects may influence perceived benefits.

Abstract

Background: Post-traumatic trigeminal neuropathy (PTTN) can significantly affect quality of life (QoL) due to pain and sensory disturbances. This study aimed to evaluate the effectiveness of photobiomodulation (PBM) therapy in patients with long-standing neurosensory disturbances associated with PTTN, using a protocol implemented at our department. Methods: A retrospective analysis was conducted on 76 cases treated between 2007 and 2018. All had neurosensory symptoms lasting more than 3 months. Data were collected from the clinical records, a structured questionnaire, and Visual Analogue Scale (VAS) scores. PBM therapy was administered using a GaAlAs diode laser. Patients were stratified based on time from injury to treatment (< 12 months vs. > 12 months). Results: Following PBM therapy, 59% of patients reported subjective improvement (30% extensive, 29% slight), while 38% reported no change and 2.6% noted slight deterioration. No statistically significant differences were observed between the groups that responded to PBM therapy and those that did not. Similarly, treatment outcomes showed no significant association with gender, etiology, affected nerve, time to treatment, or number of sessions. Conclusions: The current study did not demonstrate a statistically significant effect of PBM therapy in patients with neurosensory disturbances associated with PTTN under the applied treatment protocol. Due to the retrospective design, the absence of a control group, and the heterogeneity in patients, etiology, nerve injury types, and timing of treatment, we hypothesize that variables such as laser dosage, session intervals, and application technique may have influenced the lack of observed therapeutic benefit. Subjective improvements must be interpreted cautiously due to potential placebo effects and spontaneous nerve recovery. These findings underscore the need for standardized PBM protocols and well-designed randomized controlled trials (RCTs) to validate treatment efficacy in trigeminal nerve injuries.

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