Diode laser-assisted inferior turbinoplasty in resistant cases of allergic rhinitis: a clinical and histopathological study.

Abstract

Chronic nasal obstruction owed to inferior nasal turbinate hypertrophy is one of the most common problems encountered in rhinology. When medical management fails, surgical reduction of hyperplastic inferior nasal turbinate is often used. Diode laser is appropriate for the use in the nasal turbinate. This study was designed to define the histopathologic changes in the inferior turbinate post diode laser turbinoplasty and evaluate the outcome in patients having allergic inferior turbinate hypertrophy that has not responded to the medical treatment. A prospective single-cohort study was carried out. Under general anesthesia, 18 patients underwent inferior turbinoplasty using diode laser 980 nm in the contact mode submucosally under guidance of a 4-mm nasal endoscope 0°. Inferior turbinate mucosa biopsy specimens were taken at the time of surgery, and after 3 months, they were histopathologically examined with assessment of the patients' symptoms. At 3 months postoperatively, histopathologic assessment demonstrated marked structural changes in diode laser-treated inferior turbinates including the predominance of fibrous tissue with diminution of seromucinous glands, venous sinusoids, and inflammatory cell infiltrate. Concurrently, 16 patients (89%) had no nasal obstruction, 15 patients (83%) had moderate-to-good improvement of rhinorrhea, whereas 13 patients (72%) had moderate-to-good improvement of sneezing. Diode laser produces histopathologic changes in the inferior turbinate soft tissues, providing excellent ablation of the soft tissue with controllable performance and good hemostasis. Therefore, it is a safe, minimally invasive, and effective procedure in relieving nasal obstruction secondary to inferior turbinate hypertrophy as well as other symptoms of allergic rhinitis.