Comparison between Sifferent Surgical Interventions in Management of Postoperative Nasal Synechiae

Forty five patients complaining of nasal obstruction due to postoperative nasal synechiae were divided into 3 equal groups. Each group was subjected to different surgical intervention to treat the synechiae. The 1^st . group was treated by CO2 laser, the 2^nd group was treated using KTP laser and the 3^rd group was treated by conventional surgical excision of the nasal adhesions. Laser partial inferior turbinate reduction or partial inferior surgical turbinectomy was performed for all patients in order to widen the space between the nasal septum and the lateral nasal wall. A nasal splint was inserted postoperatively between the 2 raw surfaces in all patients Objective and subjective assessment of nasal obstruction was measured pre and postoperatively using visual analogue score and anterior rhinomanometry. Comparison between the three groups regarding the operative procedure, intra and postoperative complications was recorded. The results showed that laser techniques had superior results over the surgically treated group as regards the objective and subjective improvement of nasal obstruction, the time of operation, the convenience to the patient and the surgeon, the intra and postoperative complications and the unnecessity to insert nasal pack. Moreover, KTP laser is easier to use with minimal intraoperative bleeding and can be used under local anesthesia. The low recurrence rate in laser groups is also another advantage.