Does 810-nm Diode Laser Photobiomodulation Improve Sensory Recovery After Le Fort I Surgery?

Neurosensory disturbances are common after Le Fort I osteotomy, often transient but clinically relevant, highlighting the need for strategies to enhance recovery. Photobiomodulation (PBM) using low-level diode lasers has been proposed to accelerate nerve recovery.

The purpose of study was to compare midface sensory recovery and subject satisfaction between PBM with an 810-nm diode laser and a control side (inactive probe) following Le Fort I osteotomy.

A prospective triple-blind, split-face randomized controlled trial was conducted from 2021 to 2022 at 2 tertiary hospitals in Tehran. Eligible participants aged 18-40 years who underwent bimaxillary surgery with Le Fort I osteotomy. Exclusion criteria included trauma history, oral diseases, uncontrolled systemic diseases, and contraindications to laser therapy.

The predictor variable was the PBM treatment (810-nm GaAlAs diode laser). Treatments were randomly assigned to 1 side of the midface (PBM) while the contralateral side served as the control (inactive probe).

The primary outcome variable was time to functional sensory recovery (FSR), defined as Medical Research Council Scale S3+. It was measured using a composite of standardized neurosensory tests (2-point discrimination, brush stroke directional, and thermal and sharp/blunt discrimination). Secondary outcomes included subject satisfaction, measured with a 10-point visual analog scale.

Covariates included age, sex, and time since surgery.

Descriptive statistics, Kaplan-Meier survival analysis, repeated-measures analysis of variance, and Mann-Whitney U tests were used. Statistical significance was set at P < .05.

The study included 15 subjects (mean age 29.3 ± 7.0 years), with a 35-day follow-up. Median time to FSR was 28 days (interquartile range: 24-32) for the upper lip and 35 days (interquartile range: 30-40) for the nasolabial fold, with no statistically significant differences between PBM and control sides (Log-rank P > .05). Sensory function improved statistically significantly over time, but recovery trajectories did not differ between sides. Subject satisfaction was similar between groups.

Postoperative PBM at 810 nm did not statistically significantly accelerate FSR compared to the control side. However, it was safe and associated with improved subject satisfaction at the final follow-up, suggesting a potential role in enhancing the subjective postoperative experience.