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Abstract
Objectives It was suggested previously that turbinoplasty by laser improves the symptomatology of allergic rhinitis (AR) not only by a mechanical effect but also by inhibiting the local allergic reaction at the level of the inferior turbinates. The aim of this study was to determine whether the short-term immunologic effects of diode laser, when used to perform inferior turbinoplasty in AR, can also be detected at the systemic level. Patients and methods Twenty patients, seeking a treatment by laser for AR manifestations refractory to local and systemic medical therapy, were included in a prospective study. Blood picture, total immunoglobulin E, interleukin (IL)-4, IL-5, and interferon-γ levels were assessed immediately before and 1 month after diode laser inferior turbinoplasty (DLIT). Results One month after DLIT, the total leukocytic count increased with relative eosinopenia. Total immunoglobulin E and IL-5 decreased, together with insignificant changes in IL-4 and interferon-γ. Conclusion It is not impossible that DLIT modifies the clinical course of AR not only by a mechanical effect but also by its local or even by a systemic immunologic effect. The laser modulation of T-cell functions in the engorged turbinate submucosa is a plausible biomolecular interpretation of the observed effect.
Highlights
Allergic rhinitis (AR) is, by definition, an inflammatory reaction at the level of the nasal mucosa
We explored whether the effect of diode laser inferior turbinoplasty (DLIT), performed in AR patients, can be translated into some systemic hematologic and immunologic variables, namely, immunoglobulin E (IgE), IL-4, IL-5, and IFN-γ in peripheral blood
It was suggested that laser turbinoplasty improves the clinical symptoms in this condition by its mechanical effect and by the impact on allergic parameters resulting from decreasing the volume of the inferior turbinates [23]
Summary
Allergic rhinitis (AR) is, by definition, an inflammatory reaction at the level of the nasal mucosa. It is marked by complex interactions between the different inflammatory mediators that trigger an allergic immunoglobulin E (IgE) reaction [1,2,3]. Many AR patients present with nasal obstruction secondary to congestive hypertrophy of the inferior turbinates [7,8,9]. Fibrosis in addition to chronic congestion of the inferior turbinates makes medical therapy insufficient, opening the door for the surgical reduction of the hypertrophied turbinates [9,10] by various techniques
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