Havel Miriam, Sroka Ronald, Leunig Andreas, Patel Parag, Betz Christian S
Department of Otorhinolaryngology, Head & Neck Surgery, Ludwig Maximilian University, Munich, Germany.
Lasers Surg Med. 2011 Nov;43(9):881-6. doi: 10.1002/lsm.21128.
Various laser systems have been used for volume reduction of hyperplastic nasal turbinates. For endonasal application, fiber controlled diode lasers are preferred over conventional laser systems for reasons of cost and practicability. This study compares coagulative tissue effects using λ = 1,470 nm and λ = 940 nm lasers in treatment of hyperplastic inferior nasal turbinates in an intraindividual manner.
Twenty patients underwent laser coagulation for hyperplastic inferior nasal turbinates in this prospective, randomized, double-blind, clinical feasibility trial. In each case, one nasal cavity was treated using 1,470 nm laser (4-5 W power), the other one with 940 nm laser (12 W power), endoscopically controlled in noncontact mode. Clinical presentation and patients symptoms were documented preoperatively and on day 1, 3, 7, 14, and 21 postoperatively using rhinomanometry, standardized questionnaires including SNOT 20 GAV (German adapted version), and separate endoscopic examination, respectively.
No infections, hemorrhages, or other complications occurred intra- or postoperatively. The mean operation time was significantly shorter using the 1,470 nm diode laser as compared to the 940 nm laser. There was a significant reduction of nasal obstruction on day 21 postoperatively compared to the preoperative condition on both sides regardless of the laser system used. Evaluation of the SNOT-Scores as assessed before and 3 weeks after surgery showed significant subjective improvements.
1,470 nm diode laser system offers an efficient method for tissue reduction in hyperplasia of inferior nasal turbinate. Compared with our standard practice (940 nm diode laser), 1,470 nm diode laser application provides an equivalent tissue reduction in shorter operation time using less total energy and a comparable relief of nasal obstruction postoperatively.
各种激光系统已被用于减少增生性鼻甲的体积。对于鼻内应用，由于成本和实用性的原因，光纤控制二极管激光器比传统激光系统更受青睐。本研究以个体内方式比较了使用波长为1470nm和940nm的激光治疗增生性下鼻甲时的凝固组织效果。
在这项前瞻性、随机、双盲、临床可行性试验中，20名患者接受了增生性下鼻甲的激光凝固治疗。在每种情况下，一个鼻腔使用1470nm激光（功率4 - 5W）治疗，另一个鼻腔使用940nm激光（功率12W）治疗，在内窥镜控制下采用非接触模式。术前以及术后第1天、3天、7天、14天和21天分别使用鼻阻力测量法、包括SNOT 20 GAV（德国改编版）的标准化问卷以及单独的内镜检查记录临床表现和患者症状。
术中及术后均未发生感染、出血或其他并发症。与940nm激光相比，使用1470nm二极管激光的平均手术时间明显更短。无论使用何种激光系统，术后第21天与术前相比，两侧鼻阻塞均有显著减轻。对术前和术后3周评估的SNOT评分显示主观上有显著改善。
1470nm二极管激光系统为减少下鼻甲增生的组织提供了一种有效的方法。与我们的标准做法（940nm二极管激光）相比，应用1470nm二极管激光在更短的手术时间内使用更少的总能量实现了等效的组织减少，并且术后鼻阻塞缓解程度相当。
