Concomitant use of autologous exosomes and Nd:YAG laser in post-reconstructive treatment of Bell's palsy: A case report.

Background: Bell's palsy is the most common paralysis of the seventh cranial nerve. Recently, regenerative procedures have been proven to improve facial nerve function, reduce neuronal damage, enhance natural healing potential, and improve muscle function. Among these procedures, exosomes can be used as an effective regenerative therapeutic tool. This case presents a 49-year-old woman diagnosed with Bell's palsy grade IV with a ten-year history of left-side facial dysmorphia after facial nerve neuralgia and failed treatments. Methods: The patient was treated with a combination of injected autologous exosomes released from preconditioned platelet-rich plasma (PRP) with the MCT System and Nd:YAG laser pulses. The treatment included three sessions, three months in between, and a follow-up visit one year after the first treatment (three months after the third treatment). Results: The patient showed significant facial improvement one year after the first treatment. The paralysis degree, according to the House-Brackmann facial nerve grading scale, varied from stage IV to stage II. Changes observed were an increase in facial muscle strength, an improvement in eye closure, and an increase in smile symmetry. Conclusions: The protocol applied, combining injected preconditioned autologous platelet-rich plasma and Nd:YAG pulses, was safe and well tolerated, and the results showed significant restoration of facial appearance and resolution of Bell's palsy symptoms.