Department of Otorhinolaryngology, Head and Neck Surgery, Charité - University Medicine Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany.
Lasers Med Sci. 2011 Jan;26(1):57-67. doi: 10.1007/s10103-010-0813-x. Epub 2010 Jul 10.
The ideal treatment in severe obstructive allergic rhinitis unresponsive to standard therapy is lacking. This study aimed to evaluate the efficacy of endonasal corrective laser surgery in perennial (pAR) and seasonal (sAR) allergic rhinitis. Forty subjects (20 pAR, 20 sAR) underwent videoendoscopic diode laser surgery. Examinations were performed preoperatively and at follow-ups 1, 12, and 24 months after surgery, including objective parameters (rhinomanometry, videoendoscopy, allergy tests) and subjective visual analog scales (evaluation of surgery, satisfaction, allergic symptoms). Of all patients, 95% received inferior turbinate, 40% septal, and 15% middle turbinate surgery. Postoperatively, two subjects showed considerable residual symptomatology (95% response rate). Throughout follow-up, objective rhinomanometry and subjective scores for nasal obstruction, rhinorrhea, sneezing, itching, and overall satisfaction improved significantly with time (p < 0.0005). The improvement was greatest for nasal obstruction, initially higher in pAR but more sustained in sAR. After 2 years, 30% sAR and 40% pAR subjects had been receiving pharmacotherapy due to recurrent symptoms. The allergic condition remained unchanged (skin and in-vitro tests). Outpatient endonasal diode laser surgery appears to be effective, safe and well tolerated for treating otherwise therapy-resistant pAR and sAR, providing long-lasting symptom reduction with complete stop or decreased use of antiallergics.
对于标准治疗反应不佳的严重阻塞性过敏性鼻炎，目前缺乏理想的治疗方法。本研究旨在评估鼻内矫正激光手术对常年性（pAR）和季节性（sAR）过敏性鼻炎的疗效。40 名受试者（20 名 pAR，20 名 sAR）接受了视频内镜二极管激光手术。在术前和术后 1、12 和 24 个月进行检查，包括客观参数（鼻测压、视频内镜、过敏测试）和主观视觉模拟量表（手术评估、满意度、过敏症状）。所有患者中，95%接受了下鼻甲手术，40%接受了鼻中隔手术，15%接受了中鼻甲手术。术后，2 名患者仍有明显的残留症状（95%的反应率）。在整个随访期间，客观鼻测压和主观鼻塞、流涕、打喷嚏、瘙痒和总体满意度评分随时间显著改善（p < 0.0005）。鼻塞的改善最大，最初在 pAR 中更高，但在 sAR 中更持久。2 年后，由于症状复发，30%的 sAR 和 40%的 pAR 患者需要接受药物治疗。过敏状况保持不变（皮肤和体外测试）。门诊鼻内二极管激光手术对于治疗其他治疗抵抗性的 pAR 和 sAR 似乎是有效、安全和耐受良好的，可提供持久的症状缓解，完全停止或减少使用抗过敏药物。
