Testa B, Mesolella M, Squeglia C, Testa D, Motta G
Institute of Otolaryngology-II University of Naples, Italy.
Lasers Surg Med. 2000;27(1):49-54. doi: 10.1002/1096-9101(2000)27:1<49::aid-lsm7>3.0.co;2-y.
The argon laser was first used to treat chronic obstructive rhinitis. Several other surgical lasers were later used to perform inferior turbinotomy. What is the ideal laser for turbinate surgery?
STUDY DESIGN/MATERIALS AND METHODS: CO(2) laser with its longer wavelength (10.6 micrometer) 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 CO(2) laser energy delivered through a fiberoptic cable is partially absorbed by the transmitting fiber. CO(2) laser delivered through surgical microscope obviates this problem, and a special self-retaining nasal speculum allows the surgeon to have both hands free to more easily perform inferior laser turbinotomy, creating a deep groove along the turbinate body.
The laser vaporized tissues formed scar tissue, reduced turbinate bulk, restored nasal flow, and improved other symptoms: rhinorrhoea, sneezing, headache with a statistically significant reduction in total nasal airway resistance (NAR), P < 0.005, at 2 year follow-up.
The CO(2) laser delivered through surgical microscope with the help of a self-retaining nasal speculum can be deemed a useful laser for turbinate surgery.
氩激光首次用于治疗慢性肥厚性鼻炎。后来，其他几种外科激光也被用于下鼻甲切除术。那么，用于鼻甲手术的理想激光是什么呢？
研究设计/材料与方法：二氧化碳激光波长较长（10.6微米），在组织上散射较少，比其他外科激光危害小，能使局部水肿降至最低，对附近黏膜损伤极小，并能实现良好的止血效果。但是，通过光纤传输的二氧化碳激光能量会被传输光纤部分吸收。通过手术显微镜传输二氧化碳激光可避免这一问题，一种特殊的自固定鼻窥器能让外科医生双手自由操作，更轻松地进行下鼻甲激光切除术，沿鼻甲体形成一条深沟。
激光汽化组织形成瘢痕组织，鼻甲体积缩小，鼻通气恢复，其他症状如鼻溢、打喷嚏、头痛等也有所改善：在2年的随访中，总鼻气道阻力（NAR）有统计学意义的降低，P < 0.005。
在自固定鼻窥器的辅助下，通过手术显微镜传输的二氧化碳激光可被视为一种用于鼻甲手术的有效激光。
