Laser Assisted Turbinate Reduction (LATR) Comparative Study

One of the major causes of chronic nasal airway obstruction is the inferior turbinate hypertrophy. There is no agreement on how to deal with this problem. Surgical treatment of nasal turbinates has been indicated when medical treatment fails. Laser surgery of inferior turbinate was first described in 1977 by Lenz et al. Laser surgery of inferior turbinates can be performed as an outpatient procedure under local anesthesia. Due to a minimally invasive and controllable coagulation and ablation of soft tissue, almost no considerable complications or bleeding were observed during the operation or postoperatively, therefore no need for nasal pack. The aim of the present work is to prove the efficacy of laser-assisted turbinate reduction (LATR) and to compare between different types of lasers with different techniques in this respect. Sixty patients with irreversible turbinate hypertrophy were selected and divided into four groups; each included 15 patients:Group 1: Turbinate Reduction using CO2 laser (Non- contact technique).Group 2: Turbinate Reduction using Diode laser (Contact technique).Group 3: Turbinate Reduction using KTP laser (Interstitial technique).Group 4: Turbinate Reduction using Nd: YAG laser (Interstitial technique) All patients were be operated upon in the National Institute of Laser Enhanced Sciences (NILES) in the period between 2001 and 2004. The results of obstruction were good and satisfactory for all types of lasers until the 6th month postoperatively, after which the results became less impressive with increasing recurrence rate. Two years postoperatively, YAG cases had the lowest recurrence rate (20%), then both KTP and Diode cases (26.6%), and finally the CO2 cases that had the highest recurrence rate (about 40%). It was concluded that LATR is a good short-term alternative procedure for turbinate reduction. It is rapid safe procedure, with minimal pain and bleeding, easy done under local anesthesia as an outpatient procedure, no need for nasal packing in most cases with minimal mucosal damage specially in the interstitial technique that leaves intact mucosa. It is recommended particularly for non- allergic patients as multiple sessions to achieve relatively long-term result. On the other hand, in allergic patients the allergic manifestations alleviated to some extent but with short-term effect.