The effectiveness of low-level laser therapy for chronic rhinosinusitis: A systematic review and meta-analysis

This systematic review and meta-analysis is aimed to assess the efficacy and the safety of low-level laser therapy (LLLT) and photobiomodulation (PBMT) in the management of chronic rhinosinusitis (CRS). A comprehensive search of PubMed, SCOPUS, Embase, Web of Science, and Cochrane Library databases were conducted for studies published up to June 30th, 2025. Eligible studies included patients with CRS who underwent LLLT or PBMT, and reported quantitative outcomes. Primary outcomes were subjective symptom scores, while secondary outcomes such as headache, fatigue, and computed tomography (CT) findings were analyzed when available. Six studies including 162 patients were analyzed. LLLT or PBMT was associated with significant improvement in subjective symptom scores at 2 weeks (SMD 0.64; 95% CI [0.26; 1.01], I² = 0%, p = 0.0009), at 4 weeks (SMD 2.66; 95% CI [1.14; 4.19], I² = 92%, p = 0.0006), and at 2-6 months (SMD 0.86; 95% CI [0.39; 1.33], I² = 0%, p = 0.0003). However, no significant improvement was observed in objective CT-based measures (SMD 0.34; 95% CI [-0.01; 0.69], I² = 0%, p = 0.06), and also secondary outcomes such as headache and fatigue showed no consistent benefit. The largest effect was observed at 4 weeks, but this result should be interpreted with caution given the extreme heterogeneity across studies. LLLT and PBMT appear to provide symptomatic benefit in patients with CRS, but the evidence remains preliminary due to limited sample size and substantial heterogeneity. Larger randomized controlled trials with standardized protocols are required to validate these findings and to define the clinical role of photobiomodulation in CRS management.