Nasal Function following Carbon Dioxide Laser Turbinate Surgery for Allergy

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Abstract
A carbon dioxide laser (CO2 laser) was used to treat the hypertrophic inferior turbinates of 121 patients with nasal symptoms related to house dust allergy. Follow-up ranged from 6 to 48 months (mean follow-up period: 17.8 months). Treatment involved 10–14 watts of a defocused pulse beam of a CO2 laser fitted with special handpieces. Subjectively, 111 of the 121 patients (91.7%) reported a reduction in nasal stuffiness, 76 of the 112 patients (67.9%) had reduction in rhinorrhea, and 63 of the 96 patients (65.7%) had decrease in sneezing. Nasal airflow resistances were confirmed to have decreased in 82 patients using rhinomanometry. Nasal provocation reactions by a house dust disk, which were investigated in 10 patients, showed a tendency to reduce from 1 to 11 months after laser treatment. Nasal mucociliary transports, which were followed by the saccharin test in 50 patients, recovered 1–1.5 months after the laser surgery. To study mucosal structure after laser irradiation, the inferior turbinates of five patients were examined under a light microscope. The ciliated epithelium was shown to have recovered on light microscopic examination, whereas the number of goblet cells decreased. A net of new collagen fibers was observed in the superficial submucosa a few months after treatment. The quantity of submucosal glands was reduced in the treated portion. Such findings suggested that CO2 laser turbinate surgery may be effective in relieving the nasal symptoms associated with allergy.

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