Interstitial laser treatment of the inferior nasal turbinate for chronic nasal obstruction

Objective:

For chronic nasal obstruction (NO) with hyperplastic inferior turbinates laser treatment is a well-established procedure. It is usually performed as a surface treatment causing damage to the mucosa, although possibly being only temporary. Interstitial laser treatment may offer the best possible mucosal preservation and may provide improvement of the NO without negatively affecting sufficient conditioning and cleaning of nasal airflow. The aim of the study was to evaluate the feasibility and results of interstitial laser treatment.

Methods:

The stripped end of the quartz glass fiber of a microchip laser (WOLF TruBlue, A.R.C. Laser GmbH, Nuremberg) was guided interstitially through the turbinate. 13 patients were included in this study. Parameters were the subjective NO, rhinomanometric results and complications.

Results:

Evaluations using a visual analogue scale (VAS) and rhinomanometry showed a considerable improvement in NO. Results were comparable to the preoperative state after mucosal decongestion (VAS: preop 68, after decongestion 28; 2w postop 32. Inspiration: preop 447 ml/s, after decongestion 894 ml/s; 2w postop 815 ml/s). The effect was persistent with comparable results 6 months after surgery (numeric rating scale 3.3). No complications occurred. Five out of 6 patients with initially extended use of topical decongestants (rhinitis medicamentosa) could refrain from its use after laser treatment. Two of the 13 included patients received further nasal septoplasty.

Conclusion:

The interstitial laser treatment of the inferior turbinates has proven to be effective in patients with chronic nasal obstruction requiring no septoplasty. It can be performed under local anesthesia in an outpatient setting.

Publication History

Publication Date:
23 April 2019 (online)