Carbon dioxide laser turbinate surgery for chronic obstructive rhinitis.

OBJECTIVE

The argon laser was first used to treat chronic obstructive rhinitis. Several other surgical lasers were later used to perform inferior turbinotomy. What is the ideal laser for turbinate surgery?

METHODS

CO(2) laser with its longer wavelength (10.6 micrometer) scatters less on tissues, is less harmful than the other surgical lasers, minimizes local edema with very little damage to the nearby mucosa, and achieves excellent haemostasis. But CO(2) laser energy delivered through a fiberoptic cable is partially absorbed by the transmitting fiber. CO(2) laser delivered through surgical microscope obviates this problem, and a special self-retaining nasal speculum allows the surgeon to have both hands free to more easily perform inferior laser turbinotomy, creating a deep groove along the turbinate body.

RESULTS

The laser vaporized tissues formed scar tissue, reduced turbinate bulk, restored nasal flow, and improved other symptoms: rhinorrhoea, sneezing, headache with a statistically significant reduction in total nasal airway resistance (NAR), P < 0.005, at 2 year follow-up.

CONCLUSIONS

The CO(2) laser delivered through surgical microscope with the help of a self-retaining nasal speculum can be deemed a useful laser for turbinate surgery.