Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Otolaryngol Head Neck Surg. 2011 Feb;144(2):237-40. doi: 10.1177/0194599810390448. Epub 2010 Dec 21.
Intranasal corticosteroids (INCS) are first-line medications for moderate to severe allergic rhinitis (AR). Patients who have had nasal congestion for many years often develop inferior turbinate (IT) hypertrophy. Some patients are refractory to INCS yet decline to receive allergen-specific immunotherapy. IT reduction is then indicated. There have been very few studies evaluating the allergic biomarker changes after IT reduction in AR. This study aimed to determine the effect of potassium titanyl-phosphate (KTP) laser IT surgery on eosinophil influx after challenge with dust mites.
A randomized prospective controlled study.
Tertiary academic rhinology clinic.
Thirty-five house dust mite AR patients were randomly assigned to receive either INCS or KTP laser IT surgery. On the first visit, 2 nasal lavages prior to and 6 hours after challenge with Dermatophagiodes pteronyssinus were performed before receiving treatment. On the second visit, 3 months after treatment, the same procedures were repeated. No antiallergic medications were allowed for 2 weeks before each visit. Net changes in eosinophil numbers in the lavages were compared at baseline and 3 months after treatment and between the 2 treatments.
Treatment with KTP laser IT surgery resulted in a significant reduction in eosinophil influx after nasal challenge (P = .013), whereas such a reduction was not shown in the control. However, the net changes in the percentage of eosinophils were not different between the 2 groups at either visit.
KTP laser IT surgery reduces eosinophil influx after nasal challenge in perennial AR.
鼻内皮质类固醇（INCS）是中重度过敏性鼻炎（AR）的一线药物。有多年鼻塞史的患者常发生下鼻甲（IT）肥大。一些患者对 INCS 有抗药性，但拒绝接受过敏原特异性免疫治疗。因此需要进行 IT 缩小手术。关于 AR 患者接受 IT 缩小手术后过敏性生物标志物变化的研究很少。本研究旨在确定钛酸钾磷（KTP）激光 IT 手术对尘螨激发后嗜酸性粒细胞浸润的影响。
随机前瞻性对照研究。
三级学术鼻科诊所。
35 名屋尘螨 AR 患者被随机分为 INCS 组或 KTP 激光 IT 手术组。首次就诊时，在接受治疗前进行 2 次鼻冲洗，分别在尘螨激发前和激发后 6 小时进行。第二次就诊时，在治疗后 3 个月重复相同的程序。每次就诊前 2 周内不得使用任何抗过敏药物。比较治疗前后和两种治疗方法之间冲洗液中嗜酸性粒细胞数量的净变化。
KTP 激光 IT 手术治疗可显著减少鼻内激发后的嗜酸性粒细胞浸润（P =.013），而对照组则没有显示这种减少。然而，两次就诊时两组之间嗜酸性粒细胞百分比的净变化没有差异。
KTP 激光 IT 手术可减少常年性 AR 患者鼻内激发后的嗜酸性粒细胞浸润。
