Treatment Effect of Phototherapy with Low-Level Energy in Patients with Allergic Rhinitis: A Single-Arm Observational Study

Low-Level Laser Therapy for Allergic Rhinitis: A Systematic Review and Meta-Analysis

INTRODUCTION

Allergic rhinitis (AR) is a common allergic disorder that impairs social and physical functioning as well as quality of life. It is characterized by sneezing, rhinorrhea, congestion, and itching which respond suboptimally to drug therapy. Low-level laser therapy (LLLT) has anti-inflammatory and immunosuppressive properties that have shown promise in some studies. We aimed to systematically review LLLT's effectiveness in treating AR and meta-analyze our findings.

METHODS

A systematic search of PubMed, Scopus, and Web of Science was conducted on November 24, 2023. All studies investigating LLLT on AR were included, and a pre-post meta-analysis of nasal symptoms (rhinorrhea, nasal congestion, nasal itching, and sneezing) in the LLLT-treated arm was conducted. Rhinoconjunctivitis quality of life questionnaire (RQLQ) scores before and after LLLT were also meta-analyzed alongside a pairwise meta-analysis of LLLT with placebo, acupuncture, steroids/antihistamines, and ultraviolet lasers. A random-effects model was used with a conservative pre-post correlation of 0.4 and standardized mean difference (SMD) as the effect size.

RESULTS

Sixteen studies were included in this review, and we found that nasal symptoms are alleviated post-LLLT in people with AR (SMD: -1.4, 95 CI: [-2.07 to -1.13], p value <0.001). RQLQ scores were also reduced after LLLT (SMD = -0.72, 95 CI: [-0.94 to -0.50], p value <0.001), and very few adverse events were reported. This meta-analysis, however, had significant publication bias and heterogeneity. When compared to a placebo, LLLT did not significantly improve nasal symptoms (SMD: -0.69, p value = 0.167), which might mean the post-LLLT nasal symptom alleviation is due to a placebo effect. Comparisons to other treatment modalities were too few to deduce anything meaningful, although it does appear that LLLT is less effective than UV lasers.

CONCLUSION

LLLT is most likely effective at alleviating nasal symptomology and has a low likelihood of adverse event incidence, yet more high-quality studies with larger sample sizes are needed to compare LLLT to a placebo to ensure its superiority to the placebo effect, as well as non-inferiority clinical trials to compare it to standard treatments.

Effect of photobiomodulation therapy on headache, and fatigue in patients with chronic rhinosinusitis: a randomized controlled study

Chronic rhinosinusitis (CRS) is a debilitating disease that resists medical treatment. Photobiomodulation therapy is one of the promising treatment modalities for CRS. The purpose is to investigate the effect of photobiomodulation therapy on headache, fatigue, sinus opacification, and ostiomeatal complex obstruction in patients with CRS. Thirty-one patients with CRS were randomly divided into photobiomodulation therapy and control groups. The photobiomodulation therapy group received photobiomodulation therapy (2.5 J, frequency 9.12 Hz, and 904 nm for 10 min for 12 sessions) on eight rhinosinusitis sites, and the control group received a sham laser. Headache, fatigue, and sinus opacification outcomes were measured before and after treatment. There was a significant improvement in headache, fatigue, and sinus opacification in the photobiomodulation therapy group in comparison with the control group (p < 0.05). Photobiomodulation therapy is an effective physical therapy treatment modality for the management of CRS.Clinical trial registry: NCT05861817.