Janda P, Sroka R, Baumgartner R, Grevers G, Leunig A
Department of Oto-Rhino-Laryngology/Head & Neck Surgery, Ludwig Maximilian University, 81377 Munich, Germany.
Lasers Surg Med. 2001;28(5):404-13. doi: 10.1002/lsm.1068.
Since the early 80s various types of lasers have been used for the reduction of hyperplastic inferior nasal turbinates. Up to now many studies have revealed a variety of important information. To summarize these findings and to determine the value of laser treatment of hyperplastic inferior nasal turbinates, a comparative review of the literature was performed.
STUDY DESIGN/MATERIALS AND METHODS: The study of the literature revealed that hyperplastic inferior turbinates of more than 2,000 patients have been treated and followed up. Treatment was performed with the CO2 (10,600 nm), diode (805/810/940 nm), Argon-ion (488/514 nm), KTP (532 nm), Nd:YAG (1,064 nm), and Ho:YAG (2,080 nm) laser in more than 20 studies so far. Generally, the authors of the trials used different laser parameters (power, energy) and application modalities (contact, non-contact, interstitial, superficial). To determine the long-term results objective (active anterior rhinomanometry, acoustic rhinometry, mucociliary function tests, allergy tests) as well as subjective parameters (questionnaire) were recorded and evaluated. In some cases morphological changes of the turbinate tissue were studied by light and scanning electron microscopy (SEM).
Laser surgery of inferior turbinates can be performed as an outpatient procedure under local anesthesia. Due to a minimally invasive and controllable coagulation and ablation of soft tissue, almost no complications or bleedings were observed during the operation or postoperatively. Depending on the chosen parameters (power, energy) and the application modalities (contact, non-contact, superficial, interstitial) laser treatment of hyperplastic inferior nasal turbinates achieved comparable or better results than most of the conventional techniques for turbinate surgery like conchotomy, electrocautery, 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.
Laser treatment of hyperplastic inferior nasal turbinates can be 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 provide an excellent clinical response of the patients.
自80年代初以来，各种类型的激光已被用于治疗增生性下鼻甲。到目前为止，许多研究已经揭示了各种重要信息。为了总结这些发现并确定激光治疗增生性下鼻甲的价值，我们对相关文献进行了比较性综述。
研究设计/材料与方法：文献研究表明，已有超过2000例增生性下鼻甲患者接受了治疗并进行了随访。在迄今为止的20多项研究中，使用二氧化碳（10600纳米）、二极管（805/810/940纳米）、氩离子（488/514纳米）、KTP（532纳米）、钕：钇铝石榴石（1064纳米）和钬：钇铝石榴石（2080纳米）激光进行治疗。一般来说，试验的作者使用了不同的激光参数（功率、能量）和应用方式（接触式、非接触式、间质式、表面式）。为了确定长期结果，记录并评估了客观参数（主动前鼻测压法、鼻声反射测量法、黏液纤毛功能测试、过敏测试）以及主观参数（问卷调查）。在某些情况下，通过光学显微镜和扫描电子显微镜（SEM）研究了鼻甲组织的形态变化。
下鼻甲激光手术可在局部麻醉下作为门诊手术进行。由于软组织的微创和可控凝固及消融，手术期间或术后几乎未观察到并发症或出血。根据所选参数（功率、能量）和应用方式（接触式、非接触式、表面式、间质式），激光治疗增生性下鼻甲取得了与鼻甲手术的大多数传统技术（如鼻甲切除术、电烙术、冷冻疗法、化学烧灼术和翼管神经切除术）相当或更好的效果。从长期来看，更具侵入性（根治性）的手术方法，如下鼻甲成形术、黏膜下鼻甲切除术、外侧骨折术、部分和全鼻甲切除术，似乎比激光手术更有效。
激光治疗增生性下鼻甲可被视为一种有用、经济高效且节省时间的治疗增生性下鼻甲的方法。与其他手术方法相比，手术时间短、效果好且副作用小，为患者提供了良好的临床反应。
