Laser treatment of hyperplastic inferior nasal turbinates: A review

Background and Objective: Since the early 80s various types of lasers have been used for the reduction of hyperplastic inferior nasal turbinates. Up t o now many studies have revealed a variety of important information. To sum marize these findings and to determine the value of laser treatment of hype rplastic inferior nasal turbinates, a comparative review of the literature was performed. Study Design/Materials and Methods: The study of the literature revealed th at hyperplastic inferior turbinates of more than 2,000 patients have been t reated and followed up. Treatment was performed with the CO2 (lambda = 10,6 00 nm), diode (lambda = 805/810/940 nm), Argon-ion (lambda = 488/514 nm), K TP (lambda = 532 nm), Nd:YAG (lambda = 1,064 nm), and Ho:YAG (lambda = 2,08 0 nm) laser in more than 20 studies so far. Generally, the authors of the t rials used different laser parameters (power, energy) and application modal ities (contact, non-contact, interstitial, superficial). To determine the l ong-term results objective (active anterior rhinomanometry, acoustic rhinom etry, mucociliary function tests, allergy tests) as well as subjective para meters (questionnaire) were recorded and evaluated. In some cases morpholog ical changes of the turbinate tissue were studied by light and scanning ele ctron microscopy (SEM). Results: Laser surgery of inferior turbinates can be performed as an outpat ient procedure under local anesthesia. Due to a minimally invasive and cont rollable coagulation and ablation of soft tissue, almost no complications o r bleedings were observed during the operation or postoperatively. Dependin g on the chosen parameters (power, energy) and the application modalities ( contact, noncontact, superficial, interstitial) laser treatment of hyperpla stic inferior nasal turbinates achieved comparable or better results than m ost of the conventional techniques for turbinate surgery like conchotomy, e lectrocautery, cryotherapy, chemical cauterization, and vidian neurectomy. More invasive (radical) operative methods, such as inferior turbinoplasty, submucous turbinectomy, lateral outfracture, partial and total turbinectomy , seemed to be more effective than laser surgery in the long-term. Conclusion: Laser treatment of hyperplastic inferior nasal turbinates can b e considered as a useful, cost-effective, and time-saving procedure for the reduction of hyperplastic inferior nasal turbinates, Short operation time, good results, and minor side effects compared to other surgical methods pr ovide an excellent clinical response of the patients. (C) 2001 Wiley-Liss, Inc.