Carbon dioxide laser turbinate surgery for chronic obstructive rhinitis

Background and Objective: The argon laser was first used to treat chronic o bstructive rhinitis. Several other surgical lasers were later used to perfo rm inferior turbinotomy. What is the ideal laser for turbinate surgery? Study Design/Materials and Methods: CO2 laser with its longer wavelength (1 0.6 mu m) scatters less on tissues, is less harmful than the other surgical lasers, minimizes local edema with very little damage to the nearby mucosa , and achieves excellent haemostasis. But CO2 laser energy delivered throug h a fiberoptic cable is partially absorbed by the transmitting fiber. CO2 l aser delivered through surgical microscope obviates this problem, and a spe cial self-retaining nasal speculum allows the surgeon to have both hands fr ee to more easily perform inferior laser turbinotomy, creating a deep groov e along the turbinate body. Results: The laser vaporized tissues formed scar tissue, reduced turbinate bulk, restored nasal flow, and improved other symptoms: rhinorrhoea, sneezi ng, headache with a statistically significant reduction in total nasal airw ay resistance (NAR), P < 0.005, at 2 year follow-up. Conclusion: The CO2 laser delivered through surgical microscope with the he lp of a self-retaining nasal speculum can be deemed a useful laser for turb inate surgery. (C) 2000 Wiley-Liss, Inc.