Efeito da fotobiomodulação preventiva no edema periorbitário no pós-operatório de rinoplastia: estudo piloto

Abstract

Periorbital edema is a common manifestation following rhinoplasty and may negatively affect early recovery, patient comfort, and aesthetic perception. This pilot study evaluated the preventive effect of photobiomodulation therapy (PBMT) on postoperative periorbital edema following rhinoplasty. Participants were enrolled in a randomized, double-blind, controlled clinical trial and allocated to either a PBMT group or a sham group. The intervention consisted of a single session performed one hour before surgery using a cluster containing three red laser emitters (660 nm) and three infrared laser emitters (808 nm), applied to three points of the nasal region during the immediate preoperative period. The irradiation parameters were: wavelengths of 660 and 808 nm, output power of 150 mW per emitter, energy of 12 J per emitter, irradiation time of 80 seconds per point, radiant exposure of 108 J/cm² per emitter, total treated area of 21 cm², and total energy of 216 J(applied to 3 points, with two emitters — one red and one infrared — per point). Irradiation was delivered by direct contact to the nasal dorsum and the right and left frontal processes of the maxilla. The sham group underwent the same procedure without therapeutic light emission. The primary outcome was periorbital edema on the third postoperative day, assessed using the categorical clinical scale adapted from Hoffmann et al. (1991). Secondary outcomes included periorbital edema on the seventh postoperative day, ecchymosis, pain, medication consumption, and functional and aesthetic outcomes assessed using the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS). Statistical analyses included comparisons between groups and time points, effect size calculations, and repeated-measures analysis using the Aligned Rank Transform Analysis of Variance (ART ANOVA).The PBMT group presented significantly lower periorbital edema on the third postoperative day compared with the sham group, with significant effects of group, time, and group × time interaction. On the seventh postoperative day, edema remained numerically lower in the PBMT group, although the between-group difference was not statistically significant, and lower medication consumption was observed in the PBMT group compared with the sham group. Trends toward reduced ecchymosis and pain were also observed in the PBMT group at some time points; however, these differences did not reach statistical significance.The findings of this pilot study demonstrate that preventive photobiomodulation reduced periorbital edema on the third postoperative day and decreased medication consumption on the seventh postoperative day, suggesting that PBMT may be a promising strategy for optimizing postoperative recovery following rhinoplasty.